Y KHALID SIDDIQ (NPI# 1023085081) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1023085081 |
| Entity Type | Individual |
| Full Name | Y KHALID SIDDIQ |
| Credential | M.D. |
| Practice Address |
1700 Hospital South Dr Suite 200 Austell GA 30106-6810 |
| Practice Telephone | 7709485578 |
| Mailing Telephone | 7709485578 |
| Enumeration Date | 2006-03-08 |
| Last Update Date | 2015-01-28 |
| Gender Code | M |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 207RE0101X |
Internal Medicine Specialization: Endocrinology, Diabetes & Metabolism |
018954 | GA | Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| GA | 00152655A | 05 |
| Street Address |
1700 HOSPITAL SOUTH DR SUITE 200 |
| City | AUSTELL |
| State | GA |
| Zip Code | 30106-6810 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1215922299 | Michael Hardee | Internal Medicine | 1700 Hospital South Dr, Suite 409, Austell, GA 30106-6810 | 2005-09-15 |
| 1184284010 | West Cobb Specialty Pharmacy | Pharmacy | 1700 Hospital South Dr, Austell, GA 30106-6810 | 2019-06-13 |
| 1972017374 | Nicole Dubois Witt | Nurse Practitioner | 1700 Hospital South Dr, Austell, GA 30106-6810 | 2017-11-21 |
| 1861843815 | Kendra Chavis | Physician Assistant | 1700 Hospital South Dr, Suite #200, Austell, GA 30106-6810 | 2016-06-30 |
| 1285027649 | Karen Monica Sumner | Nurse Practitioner | 1700 Hospital South Dr, Suite 300, Austell, GA 30106-6810 | 2015-03-10 |
| 1962894576 | Hanger Prosthetics & Orthotics Inc | Durable Medical Equipment & Medical Supplies | 1700 Hospital South Dr, Suite 406, Austell, GA 30106-6810 | 2015-02-19 |
| 1790183499 | Yasmeen Girardeau | Nurse Practitioner | 1700 Hospital South Dr, Austell, GA 30106-6810 | 2014-12-11 |
| 1457766875 | Robin Christine Gohacki | Nurse Practitioner | 1700 Hospital South Dr, Suite 202, Austell, GA 30106-6810 | 2014-06-24 |
| 1053740340 | Emily A Goolsby | Advanced Practice Midwife | 1700 Hospital South Dr, Suite 500, Austell, GA 30106 | 2013-11-06 |
| 1487081105 | Michelle Lewis-austin | Nurse Practitioner | 1700 Hospital South Dr, Suite 502, Austell, GA 30106-6810 | 2013-09-27 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1073126231 | Courtney Lashune Dorsett | Nurse Practitioner | 1005 Cureton Drive, Austell, Austell, GA 30106 | 2020-08-27 |
| 1184240491 | Brian H Eves | Dietitian, Registered | 3972 Brantley Drive, Austell, GA 30106 | 2020-06-23 |
| 1669014486 | Jesse Mccoy | Registered Nurse | 3950 Austell Rd., Austell, GA 30106 | 2019-10-14 |
| 1427522820 | Envision Optics LLC | Optometrist | 1680 E West Connector, Austell, GA 30106 | 2019-01-18 |
| 1972042380 | Thomas Dental Group | Clinic/Center | 1133 East West Connector, Suite 120, Austell, GA 30106 | 2017-02-17 |
| 1245779792 | Colton Dental Group | Clinic/Center | 2495 East-west Connector, Ste 60, Austell, GA 30106 | 2017-02-16 |
| 1144691684 | Georgia Dental Professionals, PC | Dentist | 780 East West Connector Sw, Suite 108, Austell, GA 30106 | 2015-10-09 |
| 1285013714 | Ikeade Bello Alamu | Nurse Practitioner | 2870 Betula Drive, Austell, GA 30106 | 2015-05-29 |
| 1376922211 | Jessica Williams | Obstetrics & Gynecology | 1700 Hospital South Dr Ste 500, Austell, GA 30106 | 2015-05-26 |
| 1558799593 | Tonya Renee Baldwin | Speech-Language Pathologist | 4229 Brass Trl., Austell, GA 30106 | 2013-10-30 |
| Find all providers in zip 30106 | ||||
| Taxonomy Code | 207RE0101X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Internal Medicine |
| Specialization | Endocrinology, Diabetes & Metabolism |
| An internist who concentrates on disorders of the internal (endocrine) glands such as the thyroid and adrenal glands. This specialist also deals with disorders such as diabetes, metabolic and nutritional disorders, obesity, pituitary diseases and menstrual and sexual problems. |
| Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: added definition, added source; 7/1/2011: modified source] - Additional Resources: American Board of Internal Medicine, 2007. http://www.abim.org/. American Osteopathic Board of Internal Medicine, 2007. http://www.osteopathic.org/certification - Board certification for Medical Doctors (MDs) is provided by the American Board of Internal Medicine. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Internal Medicine. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1457766339 | Wellstar Medical Group, LLC | Internal Medicine | 3825 Medical Park Dr, Suite 100, Austell, GA 30106-6831 | 2014-06-30 |
| 1417116450 | Saira Adeel | Internal Medicine | 3825 Medical Park Dr, Suite 201, Austell, GA 30106-6831 | 2008-06-05 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1427606847 | Ann W Edmundson | Internal Medicine | 15685 Rowe Rd, Milton, GA 30004-2628 | 2019-08-28 |
| 1831758846 | Diabetes and Endocrinology Associates East | Internal Medicine | 1380 Milstead Ave Ne Ste H, Conyers, GA 30012-3864 | 2019-06-12 |
| 1629453428 | Ghada Mohamed Sami Ahmed K Elshimy | Internal Medicine | 1120 15th St # Hb-5025, Augusta, GA 30912-0004 | 2015-07-22 |
| 1639552920 | Shahzeena Hafeez | Internal Medicine | 550 W Peachtree St Nw, Atlanta, GA 30308 | 2015-07-03 |
| 1295122745 | Thaer Idrees | Internal Medicine | 69 Jesse Hill Jr Dr Se Ste 200, Atlanta, GA 30303-3033 | 2015-04-22 |
| 1386056372 | Camille Frances Stanback | Internal Medicine | 550 Peachtree St Ne Ste 1950, Atlanta, GA 30308-2247 | 2014-05-23 |
| 1518377654 | John Gregory Zora | Internal Medicine | 975 Johnson Ferry Rd Ste 400, Atlanta, GA 30342-4736 | 2014-04-29 |
| 1538588249 | Wedad Rahman | Internal Medicine | 1301 Sigman Rd Ne Ste 280, Conyers, GA 30012-3947 | 2014-04-09 |
| 1427493709 | Senior Medical Systems, LLC | Internal Medicine | 220 Hills Creek Rd, Taylorsville, GA 30178-2068 | 2013-05-01 |
| 1437411592 | David Antonio Reyes Umpierrez | Internal Medicine | 550 Peachtree St Ne Fl Mot19, Atlanta, GA 30308-2247 | 2012-06-13 |
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.