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General NPI Number Information
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NPI Number | 1821742677
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Entity Type | Organization
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Legal Business Name | ATLANTA WELLNESS INITIATIVE
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Dates
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Enumeration Date | 02/10/2022
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Last Update Date | 02/10/2022
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Provider Practice Location Address
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Address Line | 301 GWINNETT DR
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City | LAWRENCEVILLE
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State | GA
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Zip | 30046-5669
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Country | US
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Telephone | 470-252-7256
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Fax | 678-682-8747
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Provider Business Mailing Address
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Address Line | 301 GWINNETT DR
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City | LAWRENCEVILLE
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State | GA
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Zip | 30046-5669
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Country | US
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Telephone | 470-252-7256
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Fax | 678-682-8747
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Authorized Official
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Title or Position | OWNER
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Name | DR. SHAHZAD HASHMI
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Credential | MD
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Telephone | 470-252-7256
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QM0850X
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Taxonomy Name | Adult Mental Health Clinic/Center
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License Number |
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License Number State |
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