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NPI Code Detail

MEDICARE: HOUSTON MEDICAL ASSOCIATES, LLC

MEDICARE: HOUSTON MEDICAL ASSOCIATES, LLC
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1207R00000XInternal Medicine PhysicianGA

General Provider Information

NPI Number : 1013179670
Entity Type Code : Organization
Provider Name (Legal Business Name) : HOUSTON MEDICAL ASSOCIATES, LLC
Provider Business Mailing Address
First Line : PO BOX 4207
Second Line :
City : MACON
State : GA
Zip : 31208-4207
Country : US
Telephone Number : 478-918-0770
Fax Number : 478-918-0771
Provider Business Practice Location Address
First Line : 2054 WATSON BLVD
Second Line :
City : WARNER ROBINS
State : GA
Zip : 31093-3634
Country : US
Telephone Number : 478-918-0770
Fax Number : 478-918-0771
Authorized Official
Title or Position : PRESIDENT / OWNER
Name : DR. KHALID K AL-SHARIF
Credential : MD
Telephone Number : 478-918-0770
Provider Enumeration Date : 06/25/2008
Last Update Date : 06/27/2008

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Directions to “HOUSTON MEDICAL ASSOCIATES, LLC ” Practice Location

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