Provider Demographics
NPI:1447374426
Name:ESMAIL, NURALLAH GULAMHUSSAIN (MD)
Entity type:Individual
Prefix:DR
First Name:NURALLAH
Middle Name:GULAMHUSSAIN
Last Name:ESMAIL
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
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Mailing Address - Street 1:2145 ROSWELL RD
Mailing Address - Street 2:SUITE 80
Mailing Address - City:MARIETTA
Mailing Address - State:GA
Mailing Address - Zip Code:30062-0821
Mailing Address - Country:US
Mailing Address - Phone:770-977-6600
Mailing Address - Fax:770-977-8444
Practice Address - Street 1:2145 ROSWELL RD STE 80
Practice Address - Street 2:
Practice Address - City:MARIETTA
Practice Address - State:GA
Practice Address - Zip Code:30062-0819
Practice Address - Country:US
Practice Address - Phone:770-977-6600
Practice Address - Fax:770-977-8444
Is Sole Proprietor?:Yes
Enumeration Date:2007-03-16
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GA035623207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
GA01000648OtherAMERIGROUP
GA297510OtherWELLCARE
GA5788293OtherAETNA
GAPSHPOther00579609A
GA761991AMEOtherUNITED HEALTH CARE
GA761991AMEOtherUNITED HEALTH CARE
01BDFSZMedicare ID - Type Unspecified