Healthcare Provider Details

I. General information

NPI: 1700226545
Provider Name (Legal Business Name): ABDULLAH KHALIFAH ALMEHBASH MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/25/2013
Last Update Date: 04/23/2026
Certification Date: 04/23/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

699 BROAD ST STE 6000
AUGUSTA GA
30901-1863
US

IV. Provider business mailing address

699 BROAD ST STE 6000
AUGUSTA GA
30901-1863
US

V. Phone/Fax

Practice location:
  • Phone: 706-250-8186
  • Fax: 706-446-0018
Mailing address:
  • Phone: 706-250-8186
  • Fax: 706-446-0018

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207P00000X
TaxonomyEmergency Medicine Physician
License Number77074
License Number StateGA
# 2
Primary TaxonomyN
Taxonomy Code207P00000X
TaxonomyEmergency Medicine Physician
License Number84428
License Number StateSC

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: