MEDICARE: ALLERGY & ASTHMA OF ATLANTA, LLC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	207KA0200X	Allergy Physician	059015	GA

General Provider Information

NPI Number	:	1225158116
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	ALLERGY & ASTHMA OF ATLANTA, LLC

Provider Business Mailing Address
First Line	:	3340 PEACHTREE RD NE
Second Line	:	TOWER PLACE 100, SUITE 600
City	:	ATLANTA
State	:	GA
Zip	:	30326-1000
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	3340 PEACHTREE RD NE
Second Line	:	TOWER PLACE 100, SUITE 600
City	:	ATLANTA
State	:	GA
Zip	:	30326-1000
Country	:	US
Telephone Number	:	404-266-9876
Fax Number	:	404-266-2669

Authorized Official
Title or Position	:	PARTNER
Name	:	DR. LUQMAN SEIDU
Credential	:	M.D.
Telephone Number	:	330-289-1783

Provider Enumeration Date	:	04/02/2007
Last Update Date	:	08/22/2020

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