Provider Demographics
NPI:1427772250
Name:ALI-MOHAMMED, AIZYA (RDN)
Entity type:Individual
Prefix:
First Name:AIZYA
Middle Name:
Last Name:ALI-MOHAMMED
Suffix:
Gender:F
Credentials:RDN
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:235 HIGHLAND DR
Mailing Address - Street 2:
Mailing Address - City:MCDONOUGH
Mailing Address - State:GA
Mailing Address - Zip Code:30253-8300
Mailing Address - Country:US
Mailing Address - Phone:813-326-7025
Mailing Address - Fax:
Practice Address - Street 1:181 ARMOUR DR NE
Practice Address - Street 2:
Practice Address - City:ATLANTA
Practice Address - State:GA
Practice Address - Zip Code:30324-3916
Practice Address - Country:US
Practice Address - Phone:404-872-8089
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-09-26
Last Update Date:2022-09-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes133V00000XDietary & Nutritional Service ProvidersDietitian, RegisteredGroup - Single Specialty