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Individual

HISHAM H GOREISH

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
MD

Contact information

Practice address
150 GILBREATH DR, ONEONTA, AL 35121-2827
(205) 274-3004
(205) 274-3002
Mailing address
2416 BRYNLYN WOODS DR NE, CONYERS, GA 30013-1426
(770) 922-7664

Taxonomy

Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
46854
GA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
009914077
AL
01
051531620
BCBS
AL
05
051531620
AL
01
051531845
BCBS
AL
01
051545800
BCBS
AL
05
051557081
AL
01
7903244
AETNA
AL
Enumeration date
11/15/2005
Last updated
03/09/2022
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