| Mohammad Ali Kukaswadia, MD | |
|
4904 Timber Ridge Drive, Suite 305, Douglasville, GA 30135 | |
| (678) 501-5420 | |
| (678) 501-5427 |
| Full Name | Mohammad Ali Kukaswadia |
|---|---|
| Gender | Male |
| Speciality | Neurology |
| Experience | 34 Years |
| Location | 4904 Timber Ridge Drive, Douglasville, Georgia |
| Accepts Medicare Assignments | Yes. He accepts the Medicare-approved amount; you will not be billed for any more than the Medicare deductible and coinsurance. |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1043394109 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 2084N0400X | Psychiatry & Neurology - Neurology | GEORGIA (Georgia) | Secondary |
| 2084N0400X | Psychiatry & Neurology - Neurology | 043997 (Georgia) | Primary |
| Facility Name | Location | Facility Type |
|---|---|---|
| Northside Hospital Gwinnett | Lawrenceville, GA | Hospital |
| Northside Hospital | Atlanta, GA | Hospital |
| Group Practice Name | Group PECOS PAC ID | No. of Members |
|---|---|---|
| Northside Primary Care Professional Services,llc | 9638343924 | 282 |
| Entity Name | Northside Primary Care Professional Services,llc |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1922397553 PECOS PAC ID: 9638343924 Enrollment ID: O20111123000206 |
| Mailing Address | Practice Location Address |
|---|---|
| Mohammad Ali Kukaswadia, MD 822 Riverton Park Pl Se, Mableton, GA 30126-5685 Ph: (678) 501-5420 | Mohammad Ali Kukaswadia, MD 4904 Timber Ridge Drive, Suite 305, Douglasville, GA 30135 Ph: (678) 501-5420 |
Temitope Adeyeye, Psychiatry & Neurology Medicare: Accepting Medicare Assignments Practice Location: 6001 Professional Pkwy Ste 2020, Douglasville, GA 30134 Phone: 470-956-1570 | |
Nabila Zafar Haque, Psychiatry & Neurology Medicare: Medicare Enrolled Practice Location: 5905 Stewart Pkwy, Douglasville, GA 30135 Phone: 770-949-8082 Fax: 770-739-8916 | |
Alana Pearson, M.D. Psychiatry & Neurology Medicare: Not Enrolled in Medicare Practice Location: 4685 Dorsett Shoals Rd, Douglasville, GA 30135 Phone: 770-852-6300 |