Provider Demographics
NPI:1447011069
Name:SHAMSID-DEEN, ABDUL I
Entity type:Individual
Prefix:
First Name:ABDUL
Middle Name:I
Last Name:SHAMSID-DEEN
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:206 WOODLAND LN SW
Mailing Address - Street 2:
Mailing Address - City:MABLETON
Mailing Address - State:GA
Mailing Address - Zip Code:30126-4334
Mailing Address - Country:US
Mailing Address - Phone:404-886-7298
Mailing Address - Fax:
Practice Address - Street 1:206 WOODLAND LN SW
Practice Address - Street 2:
Practice Address - City:MABLETON
Practice Address - State:GA
Practice Address - Zip Code:30126-4334
Practice Address - Country:US
Practice Address - Phone:404-886-7298
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-01-22
Last Update Date:2024-01-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251E00000XAgenciesHome Health
No374U00000XNursing Service Related ProvidersHome Health Aide