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General NPI Number Information
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NPI Number | 1457665002
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Entity Type | Individual
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Provider Name | ANIK ANITA HAYAT M.D.
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Gender | Female
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Dates
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Enumeration Date | 08/05/2010
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Last Update Date | 06/06/2024
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Provider Practice Location Address
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Address Line | 1300 RIDENOUR BLVD NW STE 300
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City | KENNESAW
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State | GA
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Zip | 30152-4402
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Country | US
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Telephone | 770-702-1806
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Fax |
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Provider Business Mailing Address
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Address Line | 10083 SCENIC RIDGE BLVD
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City | HOLLY
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State | MI
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Zip | 48442-9349
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Country | US
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Telephone | 305-924-4228
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207L00000X
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Taxonomy Name | Anesthesiology Physician
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License Number | 81834
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License Number State | GA
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