Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 207R00000X | Internist | 70585 | GA |
N | 111NI0900X | Internist | 70585 | GA |
Y | 207RC0000X | Internist - Cardiovascular Disease | 70585 | GA |
N | 207RC0001X | Clinical Cardiac Electrophysiologist | 70585 | GA |
NPI | 1124111349 |
---|---|
Provider Name | Mustaphasahim H Shaaraoui |
First Address | Atlanta, GA 30309-1709 |
Second Address | Atlanta, GA 30309-1709 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 02/10/2006 |
Last Update Date | 10/11/2015 |