Provider Demographics
NPI:1154604874
Name:NAVEED S UMMED., M.D. INC.
Entity type:Organization
Organization Name:NAVEED S UMMED., M.D. INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:NAVEED
Authorized Official - Middle Name:SHAZ
Authorized Official - Last Name:UMMED
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:602-738-8903
Mailing Address - Street 1:5805 STATE BRIDGE RD
Mailing Address - Street 2:G150
Mailing Address - City:DULUTH
Mailing Address - State:GA
Mailing Address - Zip Code:30097-8220
Mailing Address - Country:US
Mailing Address - Phone:602-738-8903
Mailing Address - Fax:
Practice Address - Street 1:5805 STATE BRIDGE RD
Practice Address - Street 2:G150
Practice Address - City:JOHNS CREEK
Practice Address - State:GA
Practice Address - Zip Code:30097-8220
Practice Address - Country:US
Practice Address - Phone:602-738-8903
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-09-20
Last Update Date:2011-09-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GA66835207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal MedicineGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
24080OtherMEDICARE - PTAN
WY8586AOtherWYOMING MEDICAL BOARD
1841597770OtherNPI
WY222NSU11OtherWYOMING BOARD OF PHARMACY
GA66835OtherGEORGIA COMPOSITE BOARD OF MEDICINE