Healthcare Provider Details

I. General information

NPI: 1144435124
Provider Name (Legal Business Name): ABSAR AHMED M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 05/11/2007
Last Update Date: 03/07/2024
Certification Date: 03/07/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1000 JOHNSON FERRY RD
ATLANTA GA
30342
US

IV. Provider business mailing address

5605 GLENRIDGE DR STE 325
ATLANTA GA
30342-1365
US

V. Phone/Fax

Practice location:
  • Phone: 404-851-6323
  • Fax: 404-303-3747
Mailing address:
  • Phone: 678-553-7783
  • Fax: 678-553-7793

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code2085N0700X
TaxonomyNeuroradiology Physician
License Number068093
License Number StateGA
# 2
Primary TaxonomyN
Taxonomy Code2085R0202X
TaxonomyDiagnostic Radiology Physician
License Number0101281466
License Number StateVA
# 3
Primary TaxonomyN
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License Number2004015135
License Number StateMO
# 4
Primary TaxonomyY
Taxonomy Code2085R0202X
TaxonomyDiagnostic Radiology Physician
License Number068093
License Number StateGA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: