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General NPI Number Information
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NPI Number | 1891896478
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Entity Type | Individual
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Provider Name | MOHAMMED HAYTHAM AL RABBAT M.D.
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Gender | Male
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Dates
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Enumeration Date | 09/26/2006
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Last Update Date | 01/25/2012
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Provider Practice Location Address
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Address Line | 115 DUNWOODY CREEK CT
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City | ATLANTA
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State | GA
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Zip | 30350-4318
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Country | US
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Telephone | 770-379-0450
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Fax | 770-379-9203
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Provider Business Mailing Address
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Address Line | PO BOX 88564
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City | ATLANTA
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State | GA
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Zip | 30356-8564
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Country | US
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Telephone | 678-575-9093
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Fax | 770-379-9203
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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 | 2080N0001X
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Taxonomy Name | Neonatal-Perinatal Medicine Physician
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License Number | 029572
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License Number State | GA
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