Esraa F Dhabaan, M.D

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

License

070368 Issued in GA

Practice address

259 Jonesboro Rd
McDonough, GA 30253-3769

Phone

(770) 957-8666

Fax

(770) 957-0375

NPI assigned

Jun 13, 2010

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 3

Addresses

Medicare fee-for-service enrollment

Enrolled in GA

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

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

{
    "created_epoch": "1276387200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1426464000000",
    "number": "1437470549",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "290 COUNTRY CLUB DR",
            "address_2": "SUITE220",
            "city": "STOCKBRIDGE",
            "state": "GA",
            "postal_code": "302819069",
            "telephone_number": "678-284-6300",
            "fax_number": "678-284-6336"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "259 JONESBORO RD",
            "city": "MCDONOUGH",
            "state": "GA",
            "postal_code": "302533769",
            "telephone_number": "770-957-8666",
            "fax_number": "770-957-0375"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DHABAAN",
        "first_name": "ESRAA",
        "middle_name": "F",
        "name_prefix": "Dr.",
        "credential": "M.D",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2010-06-13",
        "last_updated": "2015-03-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "GA",
            "license": "070368",
            "primary": false
        },
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "GA",
            "license": "070368",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Family Medicine Physician in McDonough, GA
• Providers in McDonough, GA by specialty
• Family Medicine Physician in Georgia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 16, 2015; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.