Organization
SUMNER NEUROLOGY ASSOCIATES, PLLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. JAWAID AHSAN M.D. (OWNER)
(678) 402-1053
Entity
Organization
Contact information
Practice address
1000 JOHNSON FERRY RD BLDG F, STE.120, MARIETTA, GA 30068-2114
(678) 402-1053
(678) 402-5619
Mailing address
PO BOX 680010, MARIETTA, GA 30068-0001
(678) 402-1053
(678) 402-5619
Taxonomy
Speciality
Code
Description
License number
State
261QM1300X
Multi-Specialty Clinic/Center
Primary
16896
TN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
871643718A
—
GA
05
—
871643718A
—
TN
05
—
FA1875624
—
GA
Enumeration date
03/06/2007
Last updated
11/01/2012
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