Individual
GHULAM ILYAS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D
Contact information
Practice address
6325 HOSPITAL PKWY, JOHNS CREEK, GA 30097-5775
(516) 312-9848
Mailing address
6325 HOSPITAL PKWY, JOHNS CREEK, GA 30097-5775
(678) 474-7000
Taxonomy
Speciality
Code
Description
License number
State
207ZP0102X
Anatomic Pathology & Clinical Pathology Physician
036151147
IL
207ZP0102X
Anatomic Pathology & Clinical Pathology Physician
Primary
88046
GA
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Enumeration date
04/04/2016
Last updated
06/27/2021
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