Individual
NIZAMUDDIN KHAJA
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
101 QUARTZ DR # 103, VILLA RICA, GA 30180-3255
(770) 812-3530
(770) 812-3531
Mailing address
119 AMBULANCE DR STE 202, CARROLLTON, GA 30117-3857
(770) 812-3530
Taxonomy
Speciality
Code
Description
License number
State
2084P0800X
Psychiatry Physician
Primary
054915
GA
Other
Enumeration date
07/02/2006
Last updated
03/21/2018
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