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NPI Code Detail

MEDICARE: DR. JAWAD ILYAS M.D

MEDICARE:  DR. JAWAD  ILYAS  M.D
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 Physician4301085488MI
2207RG0100XGastroenterology Physician073151GA

General Provider Information

NPI Number : 1629276159
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. JAWAD ILYAS M.D
Provider Business Mailing Address
First Line : 550 PEACHTREE ST NE
Second Line : SUITE 1600
City : ATLANTA
State : GA
Zip : 30308-2212
Country : US
Telephone Number : 404-881-1094
Fax Number :
Provider Business Practice Location Address
First Line : 1498 JESSE JEWELL PKWY SE
Second Line : SUITE A
City : GAINESVILLE
State : GA
Zip : 30501-3874
Country : US
Telephone Number : 678-987-1498
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 07/05/2007
Last Update Date : 12/30/2015

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Directions to “ DR. JAWAD ILYAS M.D” Practice Location

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