Provider Demographics
NPI:1548919061
Name:ATLANTA NAIKA CLINIC PC
Entity type:Organization
Organization Name:ATLANTA NAIKA CLINIC PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:ABUL
Authorized Official - Middle Name:
Authorized Official - Last Name:MATIN
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:678-471-9507
Mailing Address - Street 1:1719 MOUNT VERNON RD STE A
Mailing Address - Street 2:
Mailing Address - City:DUNWOODY
Mailing Address - State:GA
Mailing Address - Zip Code:30338-4268
Mailing Address - Country:US
Mailing Address - Phone:770-394-4310
Mailing Address - Fax:770-392-0976
Practice Address - Street 1:1719 MOUNT VERNON RD STE A
Practice Address - Street 2:
Practice Address - City:DUNWOODY
Practice Address - State:GA
Practice Address - Zip Code:30338-4268
Practice Address - Country:US
Practice Address - Phone:770-394-4310
Practice Address - Fax:770-392-0976
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2022-03-22
Last Update Date:2022-03-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207RS0012XAllopathic & Osteopathic PhysiciansInternal MedicineSleep MedicineGroup - Multi-Specialty