Provider Demographics
NPI:1447887062
Name:ASHOUR, EMIR (MD)
Entity type:Individual
Prefix:DR
First Name:EMIR
Middle Name:
Last Name:ASHOUR
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:10 GLENLAKE PKWY STE 130
Mailing Address - Street 2:
Mailing Address - City:ATLANTA
Mailing Address - State:GA
Mailing Address - Zip Code:30328-3495
Mailing Address - Country:US
Mailing Address - Phone:678-353-3375
Mailing Address - Fax:
Practice Address - Street 1:10 GLENLAKE PKWY STE 130
Practice Address - Street 2:
Practice Address - City:ATLANTA
Practice Address - State:GA
Practice Address - Zip Code:30328-3495
Practice Address - Country:US
Practice Address - Phone:678-353-3375
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-03-24
Last Update Date:2022-10-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GA90546207P00000X
PAMT222366207P00000X
390200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207P00000XAllopathic & Osteopathic PhysiciansEmergency Medicine
No390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program