Individual
DR. MAZEN A ABDALLA
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
2386 CLOWER ST STE C105, SNELLVILLE, GA 30078-6107
(678) 344-0334
(678) 344-0343
Mailing address
2386 CLOWER ST STE C105, SNELLVILLE, GA 30078-6107
(678) 344-0334
(678) 344-0343
Taxonomy
Speciality
Code
Description
License number
State
207RN0300X
Nephrology Physician
Primary
038414
GA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
00612752D
—
GA
01
—
29423
LICENSE NUMBER
SC
01
—
38414
LICENSE NUMBER
GA
Enumeration date
03/10/2006
Last updated
12/10/2019
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