Provider Demographics
NPI:1063198463
Name:ABDULLAHI, AISHA ABBAS (PA-C)
Entity type:Individual
Prefix:
First Name:AISHA
Middle Name:ABBAS
Last Name:ABDULLAHI
Suffix:
Gender:F
Credentials:PA-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6135 BARFIELD RD STE 200
Mailing Address - Street 2:
Mailing Address - City:ATLANTA
Mailing Address - State:GA
Mailing Address - Zip Code:30328-4308
Mailing Address - Country:US
Mailing Address - Phone:404-256-8500
Mailing Address - Fax:
Practice Address - Street 1:6135 BARFIELD RD STE 200
Practice Address - Street 2:
Practice Address - City:ATLANTA
Practice Address - State:GA
Practice Address - Zip Code:30328-4308
Practice Address - Country:US
Practice Address - Phone:404-256-8500
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-06-22
Last Update Date:2024-05-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GA11665363AM0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363AM0700XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantMedical