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General NPI Number Information
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NPI Number | 1811519226
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Entity Type | Organization
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Legal Business Name | NORTH ATLANTA PLASTIC SURGERY GROUP LLC
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Dates
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Enumeration Date | 05/08/2020
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Last Update Date | 05/08/2020
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Provider Practice Location Address
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Address Line | 11975 MORRIS RD STE 220
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City | ALPHARETTA
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State | GA
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Zip | 30005-4444
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Country | US
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Telephone | 404-781-9094
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Fax | 770-733-1511
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Provider Business Mailing Address
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Address Line | 11877 DOUGLAS RD # 102-367
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City | JOHNS CREEK
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State | GA
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Zip | 30005-4325
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | KAMRAN ABOLMAALI
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Credential | MD
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Telephone | 404-781-9094
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 2082S0105X
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Taxonomy Name | Surgery of the Hand (Plastic Surgery) Physician
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 208200000X
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Taxonomy Name | Plastic Surgery Physician
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License Number |
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License Number State |
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Taxonomy #3
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Taxonomy Code | 2082S0099X
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Taxonomy Name | Plastic Surgery Within the Head and Neck (Plastic Surgery) Physician
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License Number |
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License Number State |
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Taxonomy #4
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Taxonomy Code | 2086S0122X
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Taxonomy Name | Plastic and Reconstructive Surgery Physician
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License Number |
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License Number State |
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