Healthcare Provider Details

I. General information

NPI: 1023834108
Provider Name (Legal Business Name): AKHLAS ABDULGADIR SAEED
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 11/23/2024
Last Update Date: 12/05/2024
Certification Date: 12/05/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1777 MONTREAL CIR
TUCKER GA
30084-6802
US

IV. Provider business mailing address

1777 MONTREAL CIR
TUCKER GA
30084-6802
US

V. Phone/Fax

Practice location:
  • Phone: 470-413-2254
  • Fax:
Mailing address:
  • Phone: 470-413-2254
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code246QM0706X
TaxonomyMedical Technologist
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: