Healthcare Provider Details

I. General information

NPI: 1699478552
Provider Name (Legal Business Name): HUZAIFA A SEIDU, MD LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 03/22/2023
Last Update Date: 08/01/2024
Certification Date: 08/01/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

931 N JEFFERSON ST NE
MILLEDGEVILLE GA
31061-2930
US

IV. Provider business mailing address

1557 WHITFIELD ST SE
SMYRNA GA
30080-2270
US

V. Phone/Fax

Practice location:
  • Phone: 678-677-3782
  • Fax:
Mailing address:
  • Phone: 678-677-3782
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2084P0800X
TaxonomyPsychiatry Physician
License Number
License Number State

VIII. Authorized Official

Name: DR. HUZAIFA ABUKARI SEIDU
Title or Position: MD
Credential:
Phone: 678-677-3782