Individual provider Active NPI

Mohamad El-Attar, M.D.

  • Specialist
  • Conyers, GA
National Provider Identifier
1235119207
Registry record updated Apr 23, 2009
On this page

Key facts

NPPES NPI Registry
Primary specialty
SpecialistTaxonomy code 174400000X
License
041286 Issued in GA
Practice address
1372 Wellbrook Circle NE
Conyers, GA 30012
Phone
(770) 483-2368
Fax
(770) 785-2489
NPI assigned
Jan 18, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 23, 2009

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Specialist 174400000X 041286 GA Primary

Addresses

Primary practice location

1372 Wellbrook Circle NE
Conyers, GA 30012

Mailing address

1372 Wellbrook Circle NE
Conyers, GA 30012
Phone (770) 483-2368

Other identifiers 2

IdentifierTypeStateIssuer
00707066DMedicaidGA
000707066DMedicaidGA

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
041286GAMDSpecialist

Practice roles

OrganizationSpecialtyStatusNew patients
East Metro OB GYN Specialists, Inc Specialist Past Accepting new patients

Organizations & group practices 1

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1137542400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1240444800000",
    "number": "1235119207",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1372 WELLBROOK CIRCLE NE",
            "city": "CONYERS",
            "state": "GA",
            "postal_code": "30012",
            "telephone_number": "770-483-2368",
            "fax_number": "770-785-2489"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1372 WELLBROOK CIRCLE NE",
            "city": "CONYERS",
            "state": "GA",
            "postal_code": "30012",
            "telephone_number": "770-483-2368",
            "fax_number": "770-785-2489"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "EL-ATTAR",
        "first_name": "MOHAMAD",
        "name_prefix": "Mr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-01-18",
        "last_updated": "2009-04-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "174400000X",
            "taxonomy_group": "",
            "desc": "Specialist",
            "state": "GA",
            "license": "041286",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00707066D",
            "state": "GA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "000707066D",
            "state": "GA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Conyers, GA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 23, 2009; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.