Provider Demographics
NPI:1033115258
Name:MATIN, ABUL FAIZ MOHAMMAD (MD, PHD)
Entity type:Individual
Prefix:DR
First Name:ABUL
Middle Name:FAIZ MOHAMMAD
Last Name:MATIN
Suffix:
Gender:M
Credentials:MD, PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:993 JOHNSON FERRY RD STE C300
Mailing Address - Street 2:
Mailing Address - City:ATLANTA
Mailing Address - State:GA
Mailing Address - Zip Code:30342-1658
Mailing Address - Country:US
Mailing Address - Phone:404-257-0080
Mailing Address - Fax:404-257-0592
Practice Address - Street 1:993 JOHNSON FERRY RD STE C300
Practice Address - Street 2:
Practice Address - City:ATLANTA
Practice Address - State:GA
Practice Address - Zip Code:30342-1658
Practice Address - Country:US
Practice Address - Phone:404-257-0080
Practice Address - Fax:404-257-0592
Is Sole Proprietor?:No
Enumeration Date:2005-06-22
Last Update Date:2024-08-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GA43697207RS0012X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RS0012XAllopathic & Osteopathic PhysiciansInternal MedicineSleep Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
GA068593807AMedicaid
GAH41687Medicare UPIN
GA11BDTJWMedicare ID - Type Unspecified