Organization Name: | MUSE MEDICAL CLINIC |
NPI Number: | 1851604862 |
Entity Type Code: | Organizational (2) |
Authorized Official Name: | JESSIE M AL-AMIN (DIRECTOR) |
Mailing Address: | 3300 Memorial Dr Suite C-1 Decatur |
State: | GA US |
Postal Code: | 300322700 |
Phone Number: | 6787329087 |
Fax Number: | 6787329088 |
NPI Enumeration Date: | 07/19/2010 |
NPI Last Update Date: | 12/16/2013 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 208D00000X |
License Number: | 039995 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | GA |
Taxonomy Type: | Allopathic & Osteopathic Physicians |
Taxonomy Classification: | General Practice |
Taxonomy Specialization: | |
Taxonomy Definition: |