Individual provider · NPI-1

Abdul I Shamsid-Deen

Home Health · Mableton, GA

NPI number1447011069
StatusActive
Last updated in NPPESJan 22, 2024

Details

NPI
1447011069
Entity type
Individual (NPI-1)
Name
Abdul I Shamsid-Deen
Sex
Male
Sole proprietor
Yes
Enumeration date
Jan 22, 2024
Certification date
Jan 20, 2024
Last updated
Jan 22, 2024

Taxonomy and licenses

Taxonomy codeDescriptionLicenseStatePrimary
251E00000X Home Health––Yes
374U00000X Home Health Aide––

Practice location

206 Woodland Ln Sw
Mableton, GA 30126-4334

Phone 404-886-7298

Mailing address

206 Woodland Ln Sw
Mableton, GA 30126-4334

Phone 404-886-7298

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