Basic Information
| Provider Information | |||||||||
| NPI: | 1023282514 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | SOLH | ||||||||
| FirstName: | MELHEM | ||||||||
| MiddleName: | |||||||||
| NamePrefix: | |||||||||
| NameSuffix: | |||||||||
| Credential: | M.D. | ||||||||
| OtherOrganizationName: | |||||||||
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| Mailing Information | |||||||||
| Address1: | 5670 PEACHTREE DUNWOODY RD | ||||||||
| Address2: | SUITE 1000 | ||||||||
| City: | ATLANTA | ||||||||
| State: | GA | ||||||||
| PostalCode: | 303421699 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 4042551930 | ||||||||
| FaxNumber: | 4044598510 | ||||||||
| Practice Location | |||||||||
| Address1: | 5670 PEACHTREE DUNWOODY RD | ||||||||
| Address2: | SUITE 1000 | ||||||||
| City: | ATLANTA | ||||||||
| State: | GA | ||||||||
| PostalCode: | 303421699 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 4042551930 | ||||||||
| FaxNumber: | 4044598510 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 04/16/2008 | ||||||||
| LastUpdateDate: | 05/24/2016 | ||||||||
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| ProviderGenderCode: | M | ||||||||
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| IsSoleProprietor: | N | ||||||||
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| NPICertificationDate: | |||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 174400000X | 71637 | GA | Y | Other Service Providers | Specialist |
ID Information
| ID | Type | State | Issuer | Description | 4301084528 | 01 | MI | MICHIGAN BOARD LICENSE | OTHER | 003155141A | 05 | GA | MEDICAID |