Healthcare Provider Details

I. General information

NPI: 1255310645
Provider Name (Legal Business Name): SABAH S TUMEH MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 01/13/2006
Last Update Date: 04/27/2012
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1968 PEACHTREE ROAD NW
ATLANTA GA
30309
US

IV. Provider business mailing address

1190 W DRUID HILLS DE NE #T-75
ATLANTA GA
30329
US

V. Phone/Fax

Practice location:
  • Phone: 404-352-1409
  • Fax:
Mailing address:
  • Phone: 404-634-9196
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2085R0202X
TaxonomyDiagnostic Radiology Physician
License Number48312
License Number StateGA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: