MEDICARE: HUSHAM P MISHU MD

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	2084N0400X	Neurology Physician	40740	GA

General Provider Information

NPI Number	:	1326022583
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	HUSHAM P MISHU MD

Provider Business Mailing Address
First Line	:	285 BOULEVARD NE STE 610
Second Line	:
City	:	ATLANTA
State	:	GA
Zip	:	30312-4212
Country	:	US
Telephone Number	:	404-653-0039
Fax Number	:	404-653-0159

Provider Business Practice Location Address
First Line	:	285 BOULEVARD NE STE 610
Second Line	:
City	:	ATLANTA
State	:	GA
Zip	:	30312-4212
Country	:	US
Telephone Number	:	404-653-0039
Fax Number	:	404-653-0159

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	12/01/2005
Last Update Date	:	12/09/2025

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