Individual
SHAJIH L MUHANNA
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
203 MEDICAL WAY, STE A, RIVERDALE, GA 30274
(770) 991-1319
(770) 991-1320
Mailing address
203 MEDICAL WAY, STE A, RIVERDALE, GA 30274
(770) 991-1319
(770) 991-1320
Taxonomy
Speciality
Code
Description
License number
State
2086S0129X
Vascular Surgery Physician
Primary
015027
GA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
000073389B
—
GA
Enumeration date
01/30/2007
Last updated
08/18/2010
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