Qasem, Khaled Ali
Qasem, Khaled Ali is an sole proprietor health care provider with primary practice located at 3073 Dunn St Se , Smyrna GA 30080-4470. He recently has only one registered license in Allopathic & Osteopathic Physicians / General Practice, which is considered as his primary health care specialty. Qasem, Khaled Ali can be contacted via phone (478) 892-3189.Contact Information
Primary practice address
3073 Dunn St Se
Smyrna GA 30080-4470
Phone: (478) 892-3189
Fax: (478) 892-3189
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Allopathic & Osteopathic Physicians / General Practice | 208D00000X | 025816 | Georgia |
Profile Details
| NPI number | 1568686145 |
|---|---|
| LBN Legal business name | Qasem, Khaled Ali |
| Credentials | Doctor of Medicine (MD) |
| Entity | Individual |
| Sole proprietor 1 | Yes |
| Enumeration date | Apr 13th, 2007 |
| Last updated | Jun 14th, 2012 - about 12 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 | 1568686145 | NPPES |
| Georgia | MEDICAID | 00275195A |
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