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Individual

SHAHED ANAM IBN FARUK

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man

Contact information

Practice address
1120 15TH ST, AUGUSTA, GA 30912-0004
(706) 721-2273
Mailing address
1120 15TH ST, AUGUSTA, GA 30912-0004
(706) 721-2273

Taxonomy

Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
7645
GA

Other

Enumeration date
07/02/2015
Last updated
07/02/2015
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