Mumtaz, Farzana B
Mumtaz, Farzana B is an individual health care provider with primary practice located at 2404 Macy Dr , Roswell GA 30076-6343. She recently has only one registered license in Allopathic & Osteopathic Physicians / Family Medicine, which is considered as her primary health care specialty. Mumtaz, Farzana B can be contacted via phone (770) 640-8814.Contact Information
Primary practice address
2404 Macy Dr
Roswell GA 30076-6343
Phone: (770) 640-8814
Fax: (770) 640-8815
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Allopathic & Osteopathic Physicians / Family Medicine | 207Q00000X | 036419 | Georgia |
Profile Details
| NPI number | 1861571291 |
|---|---|
| LBN Legal business name | Mumtaz, Farzana B |
| Credentials | Doctor of Medicine (MD) |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | Nov 5th, 2006 |
| Last updated | Jul 8th, 2007 - about 18 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.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1861571291 | NPPES |
| Georgia | Other | 000557576B | AMERIGROUP HEALTH PLAN |
| Georgia | MEDICAID | 000557576B | AMERIGROUP HEALTH PLAN |
| Georgia | Other | 319176 | AMERIGROUP HEALTH PLAN |
| Georgia | Other | P00245232 | AMERIGROUP HEALTH PLAN |
| Georgia | Other | 000557576B | AMERIGROUP HEALTH PLAN |
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