Healthcare Provider Details

I. General information

NPI: 1134566367
Provider Name (Legal Business Name): INFECTIOUS DISEASE CLINIC LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/29/2013
Last Update Date: 09/10/2025
Certification Date: 09/10/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

104 BORDERS WAY STE 400
WARNER ROBINS GA
31088-8967
US

IV. Provider business mailing address

PO BOX 14485
MACON GA
31203-4485
US

V. Phone/Fax

Practice location:
  • Phone: 478-333-2622
  • Fax:
Mailing address:
  • Phone: 478-284-2508
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License Number55016
License Number StateGA
# 2
Primary TaxonomyN
Taxonomy Code207RC0200X
TaxonomyCritical Care Medicine (Internal Medicine) Physician
License Number55016
License Number StateGA
# 3
Primary TaxonomyY
Taxonomy Code207RI0200X
TaxonomyInfectious Disease Physician
License Number55016
License Number StateGA

VIII. Authorized Official

Name: DR. AYMAN RIHAWI
Title or Position: OWNER
Credential: M.D
Phone: 478-284-2508