Organization
EASTSIDE INTERNAL MEDICINE, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
SYED WASIM M.D. (OWNER)
(678) 625-7800
Entity
Organization
Contact information
Practice address
2080 EASTSIDE DR, SUITE A, CONYERS, GA 30013-1953
(678) 625-7800
(678) 625-7888
Mailing address
2080 EASTSIDE DR, SUITE A, CONYERS, GA 30013-1953
(678) 625-7800
(678) 625-7888
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1093773905
NPI NUMBER
GA
01
—
1871551788
NPI NUMBER
GA
01
—
1992763809
NPI NUMBER
GA
Enumeration date
12/14/2006
Last updated
08/22/2020
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