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Individual

SAM A. KHAIR

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
M.D.

Contact information

Practice address
125 EAGLE SPRING DR, STOCKBRIDGE, GA 30281-6328
(770) 213-3366
(404) 962-6943
Mailing address
125 EAGLE SPRING DR, STOCKBRIDGE, GA 30281-6328
(770) 213-3366
(404) 962-6943

Taxonomy

Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
35194
GA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
000486241F
GA
01
0102000
UNITED HEALTHCARE
GA
01
080039316
RAILROAD MEDICARE
GA
01
10033142
AMERIGROUP
GA
01
1071040001
PEACHSTATE
GA
01
314129
WELLCARE
GA
01
52027054001
BC/BS GEORGIA
GA
01
7927
KAISER
GA
Enumeration date
10/24/2005
Last updated
02/27/2014
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