Individual
DR. ISLAM G ELTARAWY
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
97 HEFNER ST, SUITE 202, EAST ELLIJAY, GA 30540-8268
(706) 635-1400
(706) 635-1411
Mailing address
9766 HIGHWAY 92, SUITE 200, WOODSTOCK, GA 30188-6455
(770) 926-8717
(770) 916-4820
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
065104
GA
207Q00000X
Family Medicine Physician
53261
WI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
2733
TEP
WI
Enumeration date
10/07/2008
Last updated
05/16/2016
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