Individual
MALAKA MUSTAFA
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
303 PARKWAY DR NE, ATLANTA, GA 30312
(404) 265-4000
Mailing address
219 BEAVER CREEK LN, WOODSTOCK, GA 30189-2552
(706) 847-5252
Taxonomy
Speciality
Code
Description
License number
State
363AM0700X
Medical Physician Assistant
Primary
8714
GA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1972000404
EMERGENCY DEPARTMENT
GA
Enumeration date
04/11/2018
Last updated
07/18/2018
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