Provider Demographics
NPI:1093522369
Name:MUHAMMAD, MARYLEE TERESA (CPCS, CPMSM)
Entity type:Individual
Prefix:MS
First Name:MARYLEE
Middle Name:TERESA
Last Name:MUHAMMAD
Suffix:
Gender:F
Credentials:CPCS, CPMSM
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5918 GATEWAY BLVD
Mailing Address - Street 2:
Mailing Address - City:STONE MOUNTAIN
Mailing Address - State:GA
Mailing Address - Zip Code:30087-6057
Mailing Address - Country:US
Mailing Address - Phone:404-710-2766
Mailing Address - Fax:
Practice Address - Street 1:2701 N DECATUR RD RM 1023
Practice Address - Street 2:
Practice Address - City:DECATUR
Practice Address - State:GA
Practice Address - Zip Code:30033-5918
Practice Address - Country:US
Practice Address - Phone:404-501-5214
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-12-11
Last Update Date:2024-12-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes247200000XTechnologists, Technicians & Other Technical Service ProvidersTechnician, OtherGroup - Single Specialty