Individual
DR. SHIRAZ HABIB KASSAM
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
1380 MILSTEAD AVE NE STE B, CONYERS, GA 30012-3864
(770) 922-2424
(770) 922-8782
Mailing address
1380 MILSTEAD AVE NE STE B, CONYERS, GA 30012-3864
(770) 922-2424
(770) 922-8782
Taxonomy
Speciality
Code
Description
License number
State
207V00000X
Obstetrics & Gynecology Physician
21321
GA
207VG0400X
Gynecology Physician
Primary
21321
GA
207VX0000X
Obstetrics Physician
21321
GA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
000190506B
—
GA
Enumeration date
03/15/2006
Last updated
07/21/2022
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