Individual
AZMI A KABBANI
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
640 MARTIN LUTHER KING JR BLVD, SUITE 200, MACON, GA 31201-3206
(478) 745-5455
(478) 745-2915
Mailing address
640 MARTIN LUTHER KING JR BLVD, SUITE 200, MACON, GA 31201-3206
(478) 745-5455
(478) 745-2915
Taxonomy
Speciality
Code
Description
License number
State
207RN0300X
Nephrology Physician
Primary
31171
GA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
000459445AB
—
GA
05
—
000459445AC
—
GA
05
—
000459445AD
—
GA
05
—
000459445AE
—
GA
05
—
000459445AF
—
GA
05
—
000459445AG
—
GA
05
—
000459445AH
—
GA
05
—
000459445AI
—
GA
05
—
000459445AJ
—
GA
05
—
000459445AK
—
GA
05
—
000459445AL
—
GA
05
—
000459445B
—
GA
05
—
000459445C
—
GA
05
—
000459445D
—
GA
05
—
000459445L
—
GA
05
—
000459445M
—
GA
05
—
000459445N
—
GA
05
—
000459445P
—
GA
05
—
000459445Z
—
GA
01
—
028816
BLUE CROSS
—
01
—
110063832
RAILROAD MEDICARE
—
Enumeration date
07/07/2005
Last updated
02/17/2011
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