Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207RE0101X | Endocrinologist (Diabetes Doctor) | 019991 | GA |
NPI | 1063476810 |
---|---|
Provider Name | Dr. Yssa Saaddine |
First Address | East Point, GA 30344-3618 |
Second Address | East Point, GA 30344-3618 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 17/04/2006 |
Last Update Date | 26/09/2011 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
00205191C | (05) | GA |
D30677 | (02) | GA |