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General NPI Number Information
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NPI Number | 1457879306
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Entity Type | Organization
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Legal Business Name | BROOKSTONE RHEUMATOLOGY ASSOCIATES
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Dates
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Enumeration Date | 08/30/2017
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Last Update Date | 07/21/2022
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Provider Practice Location Address
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Address Line | 2443 BROOKSTONE CENTRE PKWY STE A
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City | COLUMBUS
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State | GA
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Zip | 31904-4664
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Country | US
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Telephone | 706-320-8900
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Fax | 706-320-8919
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Provider Business Mailing Address
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Address Line | 2443 BROOKSTONE CENTRE PKWY STE A
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City | COLUMBUS
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State | GA
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Zip | 31904-4664
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Country | US
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Telephone | 706-221-2768
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Fax | 706-221-1908
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Authorized Official
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Title or Position | PHYSICIAN
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Name | HUMA AHMED
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Credential | MD
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Telephone | 313-643-0996
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QM2500X
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Taxonomy Name | Medical Specialty Clinic/Center
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License Number | 062935
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License Number State | GA
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