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General NPI Number Information
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NPI Number | 1700914223
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Entity Type | Organization
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Legal Business Name | NORTHSIDE FAMILY MEDICINE, LLC
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Dates
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Enumeration Date | 02/28/2007
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Last Update Date | 08/22/2020
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Provider Practice Location Address
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Address Line | 580 ATLANTA RD SUITE 230-A
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City | CUMMING
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State | GA
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Zip | 30040-2744
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Country | US
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Telephone | 770-781-9824
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Fax | 770-781-9833
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Provider Business Mailing Address
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Address Line | 580 ATLANTA RD SUITE 230-A
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City | CUMMING
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State | GA
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Zip | 30040-2744
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Country | US
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Telephone | 770-781-9824
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Fax | 770-781-9833
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Authorized Official
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Title or Position | PRESIDENT
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Name | HAROON RASHID
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Credential | M.D., M.P.H.
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Telephone | 770-781-9824
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QP2300X
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Taxonomy Name | Primary Care Clinic/Center
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License Number | 049201
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License Number State | GA
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