Individual
IMRAN HASAN IFTIKHAR
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
5665 PEACHTREE DUNWOODY RD, ATLANTA, GA 30342-1764
(678) 843-7001
Mailing address
5665 PEACHTREE DUNWOODY RD, ATLANTA, GA 30342-1764
(678) 843-7001
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
30579
SC
207RP1001X
Pulmonary Disease Physician
Primary
075447
GA
207RP1001X
Pulmonary Disease Physician
30579
SC
207RP1001X
Pulmonary Disease Physician
35125869
OH
207RS0012X
Sleep Medicine (Internal Medicine) Physician
30579
SC
207RS0012X
Sleep Medicine (Internal Medicine) Physician
57
OH
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
305798
—
SC
01
—
AA69022603
MEDICARE PTAN
SC
05
—
PENDING
—
OH
Enumeration date
10/28/2008
Last updated
05/25/2016
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