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Individual

MR. MUSTAPHA TIMMY ISSA

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
CRNA

Contact information

Practice address
470 DACULA RD UNIT 145, DACULA, GA 30019-0102
(954) 547-9602
Mailing address
470 DACULA RD UNIT 145, DACULA, GA 30019-0102
(954) 547-9602

Taxonomy

Speciality
Code
Description
License number
State
367500000X
Certified Registered Nurse Anesthetist
Primary
214261
GA
367500000X
Certified Registered Nurse Anesthetist
24769
SC

Other

Enumeration date
12/26/2018
Last updated
07/11/2025
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