Individual
DR. AHMAD IBN NURIDDIN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
1040 EAGLES LANDING PKWY, SUITE 100, STOCKBRIDGE, GA 30281-9072
(770) 474-7287
(770) 389-3713
Mailing address
1040 EAGLES LANDING PKWY, SUITE 100, STOCKBRIDGE, GA 30281-9072
(770) 474-7287
(770) 389-3713
Taxonomy
Speciality
Code
Description
License number
State
208600000X
Surgery Physician
Primary
055150
GA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
918927391B
—
GA
Enumeration date
10/05/2006
Last updated
07/14/2016
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