Abdalla, Mazen A

Abdalla, Mazen A is an individual health care provider with primary practice located at 2386 Clower St Ste C105 , Snellville GA 30078-6107. He recently has only one registered license in Allopathic & Osteopathic Physicians / Nephrology, which is considered as his primary health care specialty. Abdalla, Mazen A can be contacted via phone (678) 344-0334.

Contact Information

Primary practice address
2386 Clower St Ste C105 Snellville GA 30078-6107
Phone: (678) 344-0334
Fax: (678) 344-0343
Website:
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Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Nephrology 207RN0300X 038414 Georgia

Profile Details

NPI number 1467420893
LBN Legal business name Abdalla, Mazen A
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date Mar 10th, 2006
Last updated Dec 10th, 2019 - about 5 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1467420893 NPPES
South Carolina Other 29423 LICENSE NUMBER
South Carolina MEDICAID 00612752D LICENSE NUMBER
South Carolina Other 38414 LICENSE NUMBER

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