Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 207T00000X | Neurosurgeon | 87987 | GA |
N | 2084V0102X | Vascular Neurology | 03875 | NC |
Y | 2084V0102X | Vascular Neurology | 87987 | GA |
NPI | 1043673171 |
---|---|
Provider Name | Ovais Inamullah |
First Address | Marietta, GA 30060-1101 |
Second Address | Marietta, GA 30060-1101 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 05/04/2016 |
Last Update Date | 10/11/2021 |