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General NPI Number Information
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NPI Number | 1770685547
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Entity Type | Individual
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Provider Name | MUJTABA S SHEIKH MD
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Gender | Male
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Dates
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Enumeration Date | 09/02/2006
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Last Update Date | 08/17/2023
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Provider Practice Location Address
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Address Line | 1270 FRIENDSHIP RD
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City | BRASELTON
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State | GA
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Zip | 30517-5630
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Country | US
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Telephone | 678-207-4200
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Fax | 770-533-4771
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Provider Business Mailing Address
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Address Line | PO BOX 658
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City | GAINESVILLE
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State | GA
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Zip | 30503-0658
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Country | US
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Telephone | 770-718-1122
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Fax | 770-535-7445
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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 | 208000000X
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Taxonomy Name | Pediatrics Physician
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License Number | 055702
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License Number State | GA
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