Individual
MOHAMAD SAEED S SHAHIDSALLES
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
M.D., PH.D.
Contact information
Practice address
1700 TREE LN, SUITE 350, SNELLVILLE, GA 30078-6782
(770) 978-3578
(770) 978-6630
Mailing address
1700 TREE LANE RD SUITE 160, SNELLVILLE, GA 30078
(770) 978-3578
(770) 978-6630
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
032050
GA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
000049025
—
GA
05
—
00466408B
—
GA
01
—
130022491
RAILROAD MEDICARE
GA
01
—
1952336943
HUMANA
GA
01
—
582320860
HUMANA
GA
Enumeration date
07/11/2006
Last updated
03/17/2018
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