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General NPI Number Information
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NPI Number | 1306823455
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Entity Type | Organization
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Legal Business Name | S.Y.A.H.
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Dates
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Enumeration Date | 12/29/2005
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Last Update Date | 06/19/2008
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Provider Practice Location 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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Provider Business Mailing Address
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Address Line | 1250 JESSE JEWEL PKWY 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 | DR. AYHAM YOUSEF HADDAD
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Credential | MD
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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 | 261QU0200X
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Taxonomy Name | Urgent Care Clinic/Center
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License Number |
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License Number State | GA
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