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General NPI Number Information
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NPI Number | 1629428537
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Entity Type | Individual
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Provider Name | AMMARA KHALID M.D
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Gender | Female
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Dates
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Enumeration Date | 06/21/2016
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Last Update Date | 08/16/2023
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Provider Practice Location Address
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Address Line | 226 E COLLEGE ST STE B
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City | GRIFFIN
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State | GA
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Zip | 30224-4348
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Country | US
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Telephone | 678-987-1490
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Fax | 678-987-1491
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Provider Business Mailing Address
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Address Line | 226 E COLLEGE ST STE B
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City | GRIFFIN
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State | GA
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Zip | 30224-4348
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Country | US
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Telephone | 678-987-1490
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Fax | 678-987-1491
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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 | 207R00000X
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Taxonomy Name | Internal Medicine Physician
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License Number | MT211607
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License Number State | PA
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Taxonomy #2
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Taxonomy Code | 207RG0100X
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Taxonomy Name | Gastroenterology Physician
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License Number | 90348
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License Number State | GA
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