Healthcare Provider Details

I. General information

NPI: 1093023830
Provider Name (Legal Business Name): MALIHA IQBAL JUMANI M.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/14/2010
Last Update Date: 10/01/2018
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2425 BROOKSTONE CENTRE PKWY
COLUMBUS GA
31904
US

IV. Provider business mailing address

2425 BROOKSTONE CENTRE PKWY
COLUMBUS GA
31904-4501
US

V. Phone/Fax

Practice location:
  • Phone: 706-322-1700
  • Fax: 706-320-0456
Mailing address:
  • Phone: 706-322-1700
  • Fax: 706-320-0456

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License Number244100
License Number StateMA
# 2
Primary TaxonomyY
Taxonomy Code207RE0101X
TaxonomyEndocrinology, Diabetes & Metabolism Physician
License Number244100
License Number StateGA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: