Individual
DR. AYISHA GANI
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
M.D.
Contact information
Practice address
145 RIVERSTONE TERRACE, SUITE 100, CANTON, GA 30114
(770) 704-9499
(770) 704-9754
Mailing address
145 RIVERSTONE TERRACE, SUITE 100, CANTON, GA 30114
(770) 704-9499
(770) 704-9754
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
047083
GA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
00831806A
—
GA
Enumeration date
11/16/2005
Last updated
04/05/2012
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