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NPI Verification

National Provider Identifier: 1164885901

Mariam Nematalla Antonios, D.o.

Individual Provider

Credentials

D.O.

Primary Specialty

Family Medicine

Code: 207Q00000X

All Specialties (2)

Family Medicine

Code: 207Q00000X

Family Medicine

Code: 207Q00000X

Primary

Practice Address

665 DULUTH HWY STE 501

LAWRENCEVILLE, GA 300468709

Phone: 678-312-0400

NPI Enumeration Date

March 30, 2016

NPI Number

1164885901

Data sourced from the official CMS NPPES Registry. This information is provided by the Centers for Medicare & Medicaid Services and is updated regularly.

View on CMS NPPES Registry