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General NPI Number Information
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NPI Number | 1023319134
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Entity Type | Organization
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Legal Business Name | SYAH, LLC
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Dates
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Enumeration Date | 11/04/2010
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Last Update Date | 11/04/2010
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Provider Practice Location Address
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Address Line | 7367 SPOUT SPRINGS RD SUITE 115-135
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City | FLOWERY BRANCH
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State | GA
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Zip | 30542-5519
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Country | US
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Telephone | 770-965-6464
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Fax | 770-956-6469
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Provider Business Mailing Address
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Address Line | 1250 JESSE JEWELL PKWY SE SUITE 400
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City | GAINESVILLE
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State | GA
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Zip | 30501-3871
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Country | US
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Telephone | 770-532-0800
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Fax | 770-532-0801
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Authorized Official
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Title or Position | OWNER
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Name | AYHAM HADDAD
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Credential | M.D.
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Telephone | 770-532-0800
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207Q00000X
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Taxonomy Name | Family Medicine Physician
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License Number |
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License Number State | GA
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Taxonomy #2
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Taxonomy Code | 207R00000X
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Taxonomy Name | Internal Medicine Physician
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License Number |
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License Number State | GA
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