Physician Compare National (NPI:1205031903)

HEALTHCARE PROVIDER: ALIX AMAR M.ED . MSS

Physician Compare National contains general information about individual eligible professionals (EPs) such as demographic information and Medicare quality program participation.

Individual Professional Information
NPI	1205031903
	Unique healthcare provider (clinician) ID assigned by NPPES
PECOS UID	2668651985
	Unique individual clinician ID assigned by PECOS
Professional Enrollment ID	I20200507000450
	Unique ID for the individual professional enrollment that is the source for the data in the observation
Provider Last Name	AMAR
	Individual professional last name
Provider First Name	ALIX
	Individual professional first name
Provider Gender	F
	The provider's gender if the provider is a person.

Medical School Information
Medical School Name	OTHER
	Individual professional's medical school
Graduation Year	1987
	Individual professional's medical school graduation year
Primary Specialty	CLINICAL SOCIAL WORKER
	Primary medical specialty reported by the individual professional in the selected enrollment

Practice Information
Line 1 Street Address	4796 SHAGBARK CT SW
	Group Practice or individual's line 1 address
City	LILBURN
	Group Practice or individual's city
State	GA
	Group Practice or individual's state
Zip Code	300474360
	Group Practice or individual's zip code (9 digits when available)
Phone Number	2153910996
	Phone number is listed only when there is a single phone number available for the practice location address

Hospital(s) Affiliation Information
Professional Accepts Medicare Assignment	Y