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General NPI Number Information
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NPI Number | 1093114662
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Entity Type | Organization
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Legal Business Name | YSSA SAAD DINE M D P C
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Dates
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Enumeration Date | 08/19/2014
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Last Update Date | 08/19/2014
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Provider Practice Location Address
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Address Line | 1136 CLEVELAND AVE STE#209
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City | EAST POINT
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State | GA
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Zip | 30344-3618
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Country | US
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Telephone | 404-762-8211
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Fax | 404-762-9182
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Provider Business Mailing Address
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Address Line | 1136 CLEVELAND AVE STE#209
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City | EAST POINT
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State | GA
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Zip | 30344-3618
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Country | US
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Telephone | 404-762-8211
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Fax | 404-762-9182
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Authorized Official
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Title or Position | DOCTOR
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Name | YSSA SAAD DINE
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Credential | M.D
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Telephone | 404-762-8211
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207RE0101X
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Taxonomy Name | Endocrinology, Diabetes & Metabolism Physician
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License Number | 019991
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License Number State | GA
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