Individual
IDRISSATU BAH
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
NP
Contact information
Practice address
3116 HIGHWAY 34 E, NEWNAN, GA 30265-1342
(404) 948-3019
Mailing address
3905 DUE WEST RD NW, MARIETTA, GA 30064-1019
(678) 290-5740
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
RN224670
GA
363L00000X
Nurse Practitioner
Primary
RN224670
GA
Other
Enumeration date
05/25/2020
Last updated
06/06/2023
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