Healthcare Provider Details

I. General information

NPI: 1861703159
Provider Name (Legal Business Name): ANBAR AHMAD M.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 07/01/2010
Last Update Date: 09/09/2026
Certification Date: 09/09/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

10475 MEDLOCK BRIDGE RD STE 820
JOHNS CREEK GA
30097-4437
US

IV. Provider business mailing address

10475 MEDLOCK BRIDGE RD STE 820
JOHNS CREEK GA
30097-4437
US

V. Phone/Fax

Practice location:
  • Phone: 678-224-8686
  • Fax:
Mailing address:
  • Phone: 678-224-8686
  • Fax: 678-224-8779

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207RE0101X
TaxonomyEndocrinology, Diabetes & Metabolism Physician
License Number69748
License Number StateGA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: