Individual
MARIAM K. ISHAQ
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA-C
Contact information
Practice address
470 NORTHSIDE CHEROKEE BLVD STE 480, CANTON, GA 30115-8034
(404) 845-8200
Mailing address
470 NORTHSIDE CHEROKEE BLVD STE 480, CANTON, GA 30115-8034
(404) 845-8200
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
12436
GA
Other
Enumeration date
12/09/2024
Last updated
03/02/2025
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