Healthcare Provider Details

I. General information

NPI: 1366858995
Provider Name (Legal Business Name): HAMMAD ASLAM M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/02/2014
Last Update Date: 02/11/2021
Certification Date: 02/11/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3215 MCCLURE BRIDGE RD
DULUTH GA
30096-3223
US

IV. Provider business mailing address

3215 MCCLURE BRIDGE RD
DULUTH GA
30096-3223
US

V. Phone/Fax

Practice location:
  • Phone: 678-312-6010
  • Fax: 678-312-6015
Mailing address:
  • Phone: 678-312-6010
  • Fax: 678-312-6015

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code2081P0004X
TaxonomySpinal Cord Injury Medicine Physician
License Number83433
License Number StateGA
# 2
Primary TaxonomyY
Taxonomy Code208100000X
TaxonomyPhysical Medicine & Rehabilitation Physician
License Number83433
License Number StateGA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: