Individual
MOHSIN M. HISAMUDDIN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
2655 DALLAS HWY SW, SUITE 340, MARIETTA, GA 30064-2597
(678) 797-9800
(678) 797-9801
Mailing address
2655 DALLAS HWY SW, SUITE 340, MARIETTA, GA 30064-2597
(678) 797-9800
(678) 797-9801
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
045498
GA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
000800401C
—
GA
05
—
000800401D
—
GA
Enumeration date
07/06/2006
Last updated
07/31/2023
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