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General NPI Number Information
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NPI Number | 1609446244
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Entity Type | Individual
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Provider Name | MAYAR M DESOUKI AUD
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Gender | Female
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Dates
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Enumeration Date | 06/27/2021
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Last Update Date | 06/27/2021
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Provider Practice Location Address
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Address Line | 2140 PEACHTREE RD NW STE 305
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City | ATLANTA
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State | GA
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Zip | 30309-1315
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Country | US
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Telephone | 404-351-4114
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Fax |
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Provider Business Mailing Address
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Address Line | 3464 ROXBORO RD NE UNIT 1702
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City | ATLANTA
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State | GA
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Zip | 30326-3393
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Country | US
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Telephone | 615-715-5677
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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 | 231H00000X
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Taxonomy Name | Audiologist
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License Number | AUD004286
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License Number State | GA
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