Basic Information
| Provider Information | |||||||||
| NPI: | 1215349964 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | NAZHA | ||||||||
| FirstName: | BASSEL | ||||||||
| MiddleName: | |||||||||
| NamePrefix: | DR. | ||||||||
| NameSuffix: | |||||||||
| Credential: | MD, MPH | ||||||||
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| Mailing Information | |||||||||
| Address1: | 550 PEACHTREE ST NE STE 1820 | ||||||||
| Address2: | |||||||||
| City: | ATLANTA | ||||||||
| State: | GA | ||||||||
| PostalCode: | 303082263 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 4047781900 | ||||||||
| FaxNumber: | |||||||||
| Practice Location | |||||||||
| Address1: | 550 PEACHTREE ST NE STE 1820 | ||||||||
| Address2: | |||||||||
| City: | ATLANTA | ||||||||
| State: | GA | ||||||||
| PostalCode: | 303082263 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 4047781900 | ||||||||
| FaxNumber: | |||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 05/29/2014 | ||||||||
| LastUpdateDate: | 05/12/2020 | ||||||||
| NPIDeactivationReasonCode: | |||||||||
| NPIDeactivationDate: | 01/07/2015 | ||||||||
| NPIReactivationDate: | 03/04/2015 | ||||||||
| ProviderGenderCode: | M | ||||||||
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| IsSoleProprietor: | N | ||||||||
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| NPICertificationDate: | 05/12/2020 | ||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 207RH0000X | 85166 | GA | Y | Allopathic & Osteopathic Physicians | Internal Medicine | Hematology | 390200000X | GA | N | Student, Health Care | Student in an Organized Health Care Education/Training Program |
No ID Information.