Kassam, Shiraz Habib

Kassam, Shiraz Habib is an sole proprietor health care provider with primary practice located at 1380 Milstead Ave Ne Ste B , Conyers GA 30012-3864. He recently has 3 registered licenses in different health care specialties including Allopathic & Osteopathic Physicians / Gynecology, Allopathic & Osteopathic Physicians / Obstetrics & Gynecology, Allopathic & Osteopathic Physicians / Obstetrics. Allopathic & Osteopathic Physicians / Gynecology is his primary health care specialty. Kassam, Shiraz Habib can be contacted via phone (770) 922-2424.

Contact Information

Primary practice address
1380 Milstead Ave Ne Ste B Conyers GA 30012-3864
Phone: (770) 922-2424
Fax: (770) 922-8782
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Gynecology 207VG0400X 21321 Georgia
Allopathic & Osteopathic Physicians / Obstetrics & Gynecology 207V00000X 21321 Georgia
Allopathic & Osteopathic Physicians / Obstetrics 207VX0000X 21321 Georgia

Profile Details

NPI number 1265401020
LBN Legal business name Kassam, Shiraz Habib
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 Yes
Enumeration date Mar 15th, 2006
Last updated Jul 21st, 2022 - about 3 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 1265401020 NPPES
Georgia MEDICAID 000190506B

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