Individual
IMAD ABOSSALLUE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
1000 JOHNSON FERRY RD, ATLANTA, GA 30342-1606
(404) 851-6323
(404) 303-3747
Mailing address
5605 GLENRIDGE DR STE 325, ATLANTA, GA 30342-1301
(404) 252-4709
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
2009010810
MO
207R00000X
Internal Medicine Physician
ME121864
FL
207RG0300X
Geriatric Medicine (Internal Medicine) Physician
4301102046
MI
207U00000X
Nuclear Medicine Physician
Primary
88214
GA
207U00000X
Nuclear Medicine Physician
ME121864
FL
Other
Enumeration date
07/20/2009
Last updated
06/06/2023
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