Individual
DR. HISHAM FOZI QUTOB
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
1505 NORTHSIDE BLVD STE 3500, CUMMING, GA 30041-8223
(770) 292-3120
(770) 292-3121
Mailing address
1505 NORTHSIDE BLVD STE 3500, CUMMING, GA 30041-8223
(770) 292-3120
(770) 292-3121
Taxonomy
Speciality
Code
Description
License number
State
207RC0200X
Critical Care Medicine (Internal Medicine) Physician
50856
TN
207RC0200X
Critical Care Medicine (Internal Medicine) Physician
86852
GA
207RP1001X
Pulmonary Disease Physician
50856
TN
207RP1001X
Pulmonary Disease Physician
Primary
86852
GA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
Q006605
—
TN
Enumeration date
06/17/2008
Last updated
04/04/2026
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