Individual
AYESHA IQBAL
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
P.A.
Contact information
Practice address
711 CANTON RD NE STE 300, MARIETTA, GA 30060
(678) 741-5000
(678) 819-4280
Mailing address
711 CANTON RD NE STE 300, MARIETTA, GA 30060-8949
(678) 741-5000
Taxonomy
Speciality
Code
Description
License number
State
363AM0700X
Medical Physician Assistant
Primary
007054
GA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
003141732A
—
GA
Enumeration date
12/12/2013
Last updated
12/27/2019
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