Healthcare Provider Details
I. General information
NPI: 1093650269
Provider Name (Legal Business Name): CRIMSON PRIMARY LLC
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 04/22/2026
Last Update Date: 04/22/2026
Certification Date: 04/22/2026
Deactivation Date:
Reactivation Date:
III. Provider practice location address
1815 SATELLITE BLVD STE 303
DULUTH GA
30097-5239
US
IV. Provider business mailing address
1815 SATELLITE BLVD STE 303
DULUTH GA
30097-5239
US
V. Phone/Fax
- Phone: 347-935-1364
- Fax:
- Phone: 347-935-1364
- Fax:
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 207Q00000X |
| Taxonomy | Family Medicine Physician |
| License Number | |
| License Number State | |
VIII. Authorized Official
Name:
SABEEL
KAZI
Title or Position: OWNER
Credential:
Phone: 347-935-1364