Individual
MARY JANE B KASSAM
Active
Sole proprietor
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
2020 HONEY CREEK PKWY SE, CONYERS, GA 30013-2974
(770) 929-0813
(770) 922-8653
Mailing address
2020 HONEY CREEK PKWY SE, CONYERS, GA 30013-2974
(770) 929-0813
(770) 922-8653
Taxonomy
Speciality
Code
Description
License number
State
208D00000X
General Practice Physician
Primary
033610
GA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
00447323A
—
GA
Enumeration date
07/12/2005
Last updated
07/08/2007
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