Mujtaba S Sheikh, MD | |
1270 Friendship Rd, Braselton, GA 30517-5630 | |
(678) 207-4200 | |
(770) 533-4771 |
Full Name | Mujtaba S Sheikh |
---|---|
Gender | Male |
Speciality | Pediatrics |
Location | 1270 Friendship Rd, Braselton, Georgia |
Accepts Medicare Assignments | Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs. |
Identifier | Type | State | Issuer |
---|---|---|---|
1770685547 | NPI | - | NPPES |
2928517070C | Medicaid | GA | |
424208 | Other | GA | WELLCARE |
01191774 | Other | GA | AMERIGROUP |
2928517070B | Medicaid | GA | |
582117020024 | Other | GA | TRICARE |
424145 | Other | GA | WELLCARE |
582117020030 | Other | GA | TRICARE |
2928517070D | Medicaid | GA | |
52703777 | Other | GA | BCBS |
530652 | Other | GA | WELLCARE |
582117020 | Other | GA | TRICARE |
2928517070F | Medicaid | GA | |
454241 | Other | GA | WELLCARE |
4858323 | Other | GA | CIGNA |
582117020018 | Other | GA | TRICARE |
7955625 | Other | GA | AETNA |
2928517070E | Medicaid | GA | |
454249 | Other | GA | WELLCARE |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
208000000X | Pediatrics | 055702 (Georgia) | Primary |
Entity Name | The Longstreet Clinic, Pc |
---|---|
Entity Type | Part B Supplier - Clinic/group Practice |
Entity Identifiers | NPI Number: 1326019977 PECOS PAC ID: 2668465733 Enrollment ID: O20040405001521 |
Mailing Address | Practice Location Address |
---|---|
Mujtaba S Sheikh, MD Po Box 658, Gainesville, GA 30503-0658 Ph: (770) 718-1122 | Mujtaba S Sheikh, MD 1270 Friendship Rd, Braselton, GA 30517-5630 Ph: (678) 207-4200 |
James Keelan Passmore, MD Pediatrics Medicare: Medicare Enrolled Practice Location: 2695 Old Winder Hwy, Braselton, GA 30517 Phone: 770-965-6894 |