Healthcare Provider Details

I. General information

NPI: 1831129261
Provider Name (Legal Business Name): LUQMAN SEIDU M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 07/03/2006
Last Update Date: 03/29/2016
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5671 PEACHTREE DUNWOODY SUITE 550
ATLANTA GA
30342-5000
US

IV. Provider business mailing address

5671 PEACHTREE DUNWOODY SUITE 550
ATLANTA GA
30342-5000
US

V. Phone/Fax

Practice location:
  • Phone: 404-943-0002
  • Fax: 404-943-0005
Mailing address:
  • Phone: 404-943-0002
  • Fax: 404-943-0005

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code208000000X
TaxonomyPediatrics Physician
License Number35.084875
License Number StateOH
# 2
Primary TaxonomyN
Taxonomy Code207K00000X
TaxonomyAllergy & Immunology Physician
License Number35.084875
License Number StateOH
# 3
Primary TaxonomyN
Taxonomy Code208000000X
TaxonomyPediatrics Physician
License Number059015
License Number StateGA
# 4
Primary TaxonomyY
Taxonomy Code207K00000X
TaxonomyAllergy & Immunology Physician
License Number059015
License Number StateGA
# 5
Primary TaxonomyN
Taxonomy Code2080P0201X
TaxonomyPediatric Allergy/Immunology Physician
License Number35.084875
License Number StateOH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: