Organization
THE SHAFIQ GROUP
Active
Organization subpart
No
Provider details
NPI number
Authorized official
KHALIL SHAFIQ (OWNER)
(770) 455-4088
Entity
Organization
Contact information
Practice address
910 ATHENS HWY STE K245, LOGANVILLE, GA 30052-4952
(770) 445-4088
Mailing address
910 ATHENS HWY STE K245, LOGANVILLE, GA 30052-4952
(770) 445-4088
Taxonomy
Speciality
Code
Description
License number
State
261QC1500X
Community Health Clinic/Center
Primary
—
—
Other
Enumeration date
12/16/2018
Last updated
12/16/2018
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