Healthcare Provider Details

I. General information

NPI: 1629288873
Provider Name (Legal Business Name): ASAF ALEEM, M.D. PC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/23/2007
Last Update Date: 08/22/2020
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2150 PEACHFORD RD SUITE H
ATLANTA GA
30338-6520
US

IV. Provider business mailing address

2150 PEACHFORD RD SUITE H
ATLANTA GA
30338-6520
US

V. Phone/Fax

Practice location:
  • Phone: 770-454-1252
  • Fax: 770-454-1256
Mailing address:
  • Phone: 770-454-1252
  • Fax: 770-454-1256

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2084P0800X
TaxonomyPsychiatry Physician
License Number030260
License Number StateGA

VIII. Authorized Official

Name: CHRISTINE ALEEM
Title or Position: OFFICE MGR
Credential:
Phone: 770-454-1252