Healthcare Provider Details

I. General information

NPI: 1851939847
Provider Name (Legal Business Name): SANIYA AHMED PA-C
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 12/20/2019
Last Update Date: 04/30/2026
Certification Date: 04/30/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

81 NORTHSIDE DAWSON DR STE 100
DAWSONVILLE GA
30534-7164
US

IV. Provider business mailing address

3203 AVENEL CT
SNELLVILLE GA
30078-3257
US

V. Phone/Fax

Practice location:
  • Phone: 678-225-7500
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363A00000X
TaxonomyPhysician Assistant
License NumberPA20074
License Number StateTX
# 2
Primary TaxonomyN
Taxonomy Code363AM0700X
TaxonomyMedical Physician Assistant
License Number
License Number StateNULL
# 3
Primary TaxonomyN
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License Number10089
License Number StateGA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: