Provider Demographics
NPI:1285125310
Name:ABBASI, SUZANNE NURIYE (MD)
Entity type:Individual
Prefix:MRS
First Name:SUZANNE
Middle Name:NURIYE
Last Name:ABBASI
Suffix:
Gender:F
Credentials:MD
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Mailing Address - Street 1:PO BOX 2510
Mailing Address - Street 2:
Mailing Address - City:EVANS
Mailing Address - State:GA
Mailing Address - Zip Code:30809-2510
Mailing Address - Country:US
Mailing Address - Phone:706-922-8251
Mailing Address - Fax:706-922-6695
Practice Address - Street 1:4039 GATEWAY BLVD
Practice Address - Street 2:
Practice Address - City:GROVETOWN
Practice Address - State:GA
Practice Address - Zip Code:30813-3389
Practice Address - Country:US
Practice Address - Phone:706-922-1600
Practice Address - Fax:706-922-1010
Is Sole Proprietor?:No
Enumeration Date:2018-05-24
Last Update Date:2024-05-23
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
GA87651207Q00000X, 207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
GA87651OtherLICENSE
GAFA0519655OtherDEA