Healthcare Provider Details

I. General information

NPI: 1376080903
Provider Name (Legal Business Name): QAREEB J RA'OOF RRT, RCP
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 01/20/2017
Last Update Date: 02/08/2017
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2525 CUMBERLAND PARKWAY KAISER PERMANENTE CUMBERLAND MEDICAL CENTER
ATLANTA GA
30339
US

IV. Provider business mailing address

3495 PIEDMONT ROAD, NE NINE PIEDMONT CENTER
ATLANTA GA
30305
US

V. Phone/Fax

Practice location:
  • Phone: 404-504-5678
  • Fax:
Mailing address:
  • Phone: 404-504-5678
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code227800000X
TaxonomyCertified Respiratory Therapist
License Number7989
License Number StateGA
# 2
Primary TaxonomyY
Taxonomy Code227900000X
TaxonomyRegistered Respiratory Therapist
License Number007989
License Number StateGA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: