Basic Information
Provider Information
NPI: 1992011175
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: AL-HELOU
FirstName: GEORGES
MiddleName:  
NamePrefix: DR.
NameSuffix:  
Credential: MD
OtherOrganizationName:  
OtherOrganizationType:  
OtherLastName:  
OtherFirstName:  
OtherMiddleName:  
OtherNamePrefix:  
OtherNameSuffix:  
OtherCredential:  
OtherLastNameType:  
Mailing Information
Address1: PO BOX 102847
Address2:  
City: ATLANTA
State: GA
PostalCode: 303682847
CountryCode: US
TelephoneNumber:  
FaxNumber:  
Practice Location
Address1: 1412 MILSTEAD AVE NE
Address2:  
City: CONYERS
State: GA
PostalCode: 300123877
CountryCode: US
TelephoneNumber: 4043500009
FaxNumber:  
Other Information
ProviderEnumerationDate: 08/25/2010
LastUpdateDate: 07/30/2021
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: M
AuthorizedOfficialLastName:  
AuthorizedOfficialFirstName:  
AuthorizedOfficialMiddleName:  
AuthorizedOfficialTitleorPosition:  
AuthorizedOfficialTelephone:  
IsSoleProprietor: N
IsOrganizationSubpart:  
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate: 07/30/2021

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
207RC0200X88197GAY Allopathic & Osteopathic PhysiciansInternal MedicineCritical Care Medicine
207RP1001XC1-0012639DEN Allopathic & Osteopathic PhysiciansInternal MedicinePulmonary Disease

No ID Information.


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