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NPI Code Detail

MEDICARE: SHARIFA RUQAYAH AVERY MD

MEDICARE: SHARIFA RUQAYAH AVERY 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
1207R00000XInternal Medicine Physician81025GA
2390200000XStudent in an Organized Health Care Education/Training Program

General Provider Information

NPI Number : 1528440773
Entity Type Code : Individual
Provider Name (Legal Business Name) : SHARIFA RUQAYAH AVERY MD
Provider Business Mailing Address
First Line : 306 CREEKBANK WAY SE
Second Line :
City : SMYRNA
State : GA
Zip : 30082-4889
Country : US
Telephone Number : 678-264-6498
Fax Number : 678-736-7919
Provider Business Practice Location Address
First Line : 4300 PACES FERRY RD SE STE 500
Second Line :
City : ATLANTA
State : GA
Zip : 30339-5714
Country : US
Telephone Number : 678-264-6498
Fax Number : 678-736-7919
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 06/24/2015
Last Update Date : 05/21/2026

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Directions to “ SHARIFA RUQAYAH AVERY MD” Practice Location

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