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Individual

NABIL LUTFI MUHANNA

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
M.D.

Contact information

Practice address
655 JESSE JEWELL PKWY SE, GAINESVILLE, GA 30501-3854
(770) 533-7288
(770) 534-9800
Mailing address
2128 VALLEY RD NE, GAINESVILLE, GA 30501-1237
(678) 206-3204

Taxonomy

Speciality
Code
Description
License number
State
173000000X
Legal Medicine
023643
GA
207T00000X
Neurological Surgery Physician
Primary
023643
GA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
000254812D
GA
05
000254812E
GA
01
01351948
AMERIGROUP
GA
01
52053670
BCBS
GA
01
558244
WELLCARE
GA
Enumeration date
12/07/2005
Last updated
02/09/2023
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