Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 2082S0105X | Plastic Hand Surgeon | 76039 | GA |
Y | 2086S0122X | Plastic and Reconstructive Surgery | 76039 | GA |
N | 2086S0122X | Plastic and Reconstructive Surgery | A160974 | CA |
NPI | 1215370432 |
---|---|
Provider Name | Paul A Ghareeb |
First Address | Atlanta, GA 30342-1804 |
Second Address | Atlanta, GA 30342-1804 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 08/04/2013 |
Last Update Date | 17/09/2020 |