Individual
OMAR AL-RUSAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
1364 CLIFTON RD NE, ATLANTA, GA 30322-1059
(404) 712-5227
Mailing address
1364 CLIFTON RD NE, ATLANTA, GA 30322-1059
Taxonomy
Speciality
Code
Description
License number
State
207ZP0102X
Anatomic Pathology & Clinical Pathology Physician
Primary
13345
GA
Other
Enumeration date
07/19/2021
Last updated
07/19/2021
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