Healthcare Provider Details

I. General information

NPI: 1730687880
Provider Name (Legal Business Name): SERENITY AND HEAL, INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 01/24/2018
Last Update Date: 01/24/2018
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

6593 MCEVER RD
FLOWERY BRANCH GA
30542-3860
US

IV. Provider business mailing address

2150 PEACHFORD RD STE A
ATLANTA GA
30338-6521
US

V. Phone/Fax

Practice location:
  • Phone: 770-674-0553
  • Fax:
Mailing address:
  • Phone: 770-674-0553
  • Fax: 770-674-0554

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2084B0040X
TaxonomyBehavioral Neurology & Neuropsychiatry Physician
License Number66835
License Number StateGA

VIII. Authorized Official

Name: DR. NAVEED UMMED
Title or Position: OWNER
Credential: MD
Phone: 770-674-0553