Individual
MARYAM RIAZ
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
1160 CAPITAL AVE STE 105, WATKINSVILLE, GA 30677-1832
(706) 946-4041
Mailing address
PO BOX 459, COLBERT, GA 30628-0459
Taxonomy
Speciality
Code
Description
License number
State
363AM0700X
Medical Physician Assistant
Primary
12575
GA
Other
Enumeration date
09/26/2022
Last updated
05/05/2026
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