Provider Demographics
NPI:1154949261
Name:ALJABI, MOHAMMAD ZAID (OD)
Entity type:Individual
Prefix:DR
First Name:MOHAMMAD
Middle Name:ZAID
Last Name:ALJABI
Suffix:
Gender:M
Credentials:OD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3781 ELMSIDE VILLAGE LN APT J
Mailing Address - Street 2:
Mailing Address - City:NORCROSS
Mailing Address - State:GA
Mailing Address - Zip Code:30092-4889
Mailing Address - Country:US
Mailing Address - Phone:205-475-4958
Mailing Address - Fax:
Practice Address - Street 1:5505 PEACHTREE DUNWOODY RD STE 300
Practice Address - Street 2:
Practice Address - City:ATLANTA
Practice Address - State:GA
Practice Address - Zip Code:30342-1713
Practice Address - Country:US
Practice Address - Phone:404-257-0814
Practice Address - Fax:404-843-8521
Is Sole Proprietor?:No
Enumeration Date:2020-07-07
Last Update Date:2020-07-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GAOPT003246152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist
Provider Identifiers
StateIdentifier IDID TypeIssuer
GAOPT003246OtherGEORGIA BOARD OF OPTOMETRY