Umm Habibah Sadaqa Abduljalil
Individual provider Active NPI Driver · Lawrenceville, GA
NPI 1942016126 · NPPES record last updated Dec 3, 2024
Key facts
- NPI
- 1942016126
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Driver 172A00000X
- License
- 053176244 (GA)
- Practice address
- 1165 Pennefeather LN
Lawrenceville, GA 30043-4714 - Phone
- (404) 707-6442
- NPI assigned
- Dec 3, 2024
- Sex
- Female
- Sole proprietor
- Yes
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- No
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 053176244 | GA | MD | Driver |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Driver | 172A00000X | 053176244 | GA | Yes |
Addresses
Primary practice location
1165 Pennefeather LN
Lawrenceville, GA 30043-4714
Mailing address
1165 Pennefeather LN
Lawrenceville, GA 30043-4714
Phone (404) 707-6442
Other providers in Lawrenceville, GA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Dec 3, 2024. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.