Individual
INTISAR ALI GHLEILIB
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
1120 15TH ST, AUGUSTA, GA 30912-0004
(706) 721-2092
Mailing address
1120 15TH ST, AUGUSTA, GA 30912-0004
(706) 721-2092
Taxonomy
Speciality
Code
Description
License number
State
207ZP0102X
Anatomic Pathology & Clinical Pathology Physician
Primary
009806
GA
Other
Enumeration date
09/29/2017
Last updated
07/21/2022
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