Basic Information
Provider Information
NPI: 1972718328
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: EL-AMIN
FirstName: SAADIQ FARID
MiddleName:  
NamePrefix:  
NameSuffix: III
Credential: MD
OtherOrganizationName:  
OtherOrganizationType:  
OtherLastName:  
OtherFirstName:  
OtherMiddleName:  
OtherNamePrefix:  
OtherNameSuffix:  
OtherCredential:  
OtherLastNameType:  
Mailing Information
Address1: 3855 PLEASANT HILL RD STE 270
Address2:  
City: DULUTH
State: GA
PostalCode: 300968093
CountryCode: US
TelephoneNumber: 6782577078
FaxNumber: 6786692619
Practice Location
Address1: 3855 PLEASANT HILL RD STE 270
Address2:  
City: DULUTH
State: GA
PostalCode: 300968093
CountryCode: US
TelephoneNumber: 6782577078
FaxNumber: 6786692619
Other Information
ProviderEnumerationDate: 05/11/2007
LastUpdateDate: 03/12/2020
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: M
AuthorizedOfficialLastName:  
AuthorizedOfficialFirstName:  
AuthorizedOfficialMiddleName:  
AuthorizedOfficialTitleorPosition:  
AuthorizedOfficialTelephone:  
IsSoleProprietor: N
IsOrganizationSubpart:  
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate: 03/12/2020

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
207X00000X74882GAY Allopathic & Osteopathic PhysiciansOrthopaedic Surgery 

No ID Information.


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