Individual
ASIF N TAHIR
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
1133 EAGLES LANDING PKWY, STOCKBRIDGE, GA 30281
(678) 604-1061
Mailing address
1133 EAGLES LANDING PKWY, STOCKBRIDGE, GA 30281-5085
(678) 604-1061
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
036.115720
IL
207R00000X
Internal Medicine Physician
079478
GA
208100000X
Physical Medicine & Rehabilitation Physician
Primary
79478
GA
2083P0011X
Undersea and Hyperbaric Medicine (Preventive Medicine) Physician
079478
GA
208M00000X
Hospitalist Physician
079478
GA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0-628-692-6
ECFMG
—
01
—
036115720
ILLINOIS MEDICAL LICENSE
IL
05
—
1750329728
—
MO
01
—
2008023315
MO MEDICAL LICENSE
MO
Enumeration date
06/03/2006
Last updated
06/25/2024
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