Individual
HARUKI ISHII
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
1968 HAWKS LN NE, BROOKHAVEN, GA 30329-2283
(404) 778-7142
Mailing address
1968 HAWKS LN NE, BROOKHAVEN, GA 30329-2283
(404) 778-7142
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
010056
GA
2081S0010X
Sports Medicine (Physical Medicine & Rehabilitation) Physician
Primary
95121
GA
390200000X
Student in an Organized Health Care Education/Training Program
010056
NY
Other
Enumeration date
06/07/2018
Last updated
07/01/2023
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