| Mr Mustapha Timmy Issa, CRNA | |
|
470 Dacula Rd Unit 145, Dacula, GA 30019-0102 | |
| (954) 547-9602 | |
| Not Available |
| Full Name | Mr Mustapha Timmy Issa |
|---|---|
| Gender | Male |
| Speciality | Certified Registered Nurse Anesthetist (crna) |
| Experience | 8 Years |
| Location | 470 Dacula Rd Unit 145, Dacula, Georgia |
| Accepts Medicare Assignments | May be. He may accept the Medicare-approved amount; you may be billed for more than the Medicare deductible and coinsurance. |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1497227797 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 367500000X | Nurse Anesthetist, Certified Registered | 24769 (South Carolina) | Secondary |
| 367500000X | Nurse Anesthetist, Certified Registered | 214261 (Georgia) | Primary |
| Facility Name | Location | Facility Type |
|---|---|---|
| Wellstar Cobb Hospital | Austell, GA | Hospital |
| Providence Health | Columbia, SC | Hospital |
| Group Practice Name | Group PECOS PAC ID | No. of Members |
|---|---|---|
| Mak Anesthesia Holdings, Llc | 4284917204 | 169 |
| Mak Anesthesia Georgia, Llc | 7315203718 | 92 |
| Musc Community Physicians | 6507260668 | 984 |
| Entity Name | Medical Center Anesthesiology Of Athens |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1003863291 PECOS PAC ID: 1456246230 Enrollment ID: O20040219000797 |
| Entity Name | American Anesthesiology Associates Of Georgia Llc |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1528068673 PECOS PAC ID: 7618934779 Enrollment ID: O20041210000442 |
| Entity Name | Phoebe Physician Group Inc |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1487899464 PECOS PAC ID: 8426112350 Enrollment ID: O20090121000583 |
| Entity Name | Concordia Anesthesiology Inc |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1619296464 PECOS PAC ID: 8325172885 Enrollment ID: O20100819000220 |
| Entity Name | Mak Anesthesia Holdings, Llc |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1912452939 PECOS PAC ID: 4284917204 Enrollment ID: O20170216001563 |
| Entity Name | Mak Anesthesia Northside Affiliates Llc |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1609390103 PECOS PAC ID: 7315203718 Enrollment ID: O20171116002499 |
| Entity Name | Radius Anesthesia Of Georgia Llc |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1861996225 PECOS PAC ID: 2567897127 Enrollment ID: O20200109000552 |
| Entity Name | Piedmont Anesthesia Llc |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1700474244 PECOS PAC ID: 2163837972 Enrollment ID: O20210208002823 |
| Entity Name | Anesthesia Services Of Atlanta, Llc |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1124657465 PECOS PAC ID: 6406252949 Enrollment ID: O20210908001767 |
| Mailing Address | Practice Location Address |
|---|---|
| Mr Mustapha Timmy Issa, CRNA 470 Dacula Rd Unit 145, Dacula, GA 30019-0102 Ph: (954) 547-9602 | Mr Mustapha Timmy Issa, CRNA 470 Dacula Rd Unit 145, Dacula, GA 30019-0102 Ph: (954) 547-9602 |