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General NPI Number Information
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NPI Number | 1891726121
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Entity Type | Individual
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Provider Name | MOHAMAD M KASSEM M.D.
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Gender | Male
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Dates
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Enumeration Date | 07/05/2006
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Last Update Date | 12/12/2013
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Provider Practice Location Address
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Address Line | 3580 CAMERON PARKWAY
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City | STOCKBRIDGE
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State | GA
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Zip | 30281
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Country | US
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Telephone | 770-996-6446
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Fax | 770-996-6279
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Provider Business Mailing Address
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Address Line | 3580 CAMERON PARKWAY
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City | STOCKBRIDGE
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State | GA
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Zip | 30281
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Country | US
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Telephone | 770-996-6446
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Fax | 770-996-6279
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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 | 207RN0300X
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Taxonomy Name | Nephrology Physician
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License Number | 040934
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License Number State | GA
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