Healthcare Provider Details

I. General information

NPI: 1952833881
Provider Name (Legal Business Name): DR. OMAR RASHID
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 03/30/2017
Last Update Date: 04/01/2021
Certification Date: 04/01/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1110 W PEACHTREE ST NW STE 830
ATLANTA GA
30309-3609
US

IV. Provider business mailing address

3400C OLD MILTON PKWY STE 270
ALPHARETTA GA
30005-4438
US

V. Phone/Fax

Practice location:
  • Phone: 770-442-1911
  • Fax:
Mailing address:
  • Phone: 777-442-1911
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code390200000X
TaxonomyStudent in an Organized Health Care Education/Training Program
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License Number87531
License Number StateGA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: