Provider Demographics
NPI:1053399626
Name:SOLTAN, ALAA EL-DIN (MD)
Entity type:Individual
Prefix:DR
First Name:ALAA EL-DIN
Middle Name:
Last Name:SOLTAN
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
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Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:1835 SAVOY DR
Mailing Address - Street 2:SUITE 300
Mailing Address - City:ATLANTA
Mailing Address - State:GA
Mailing Address - Zip Code:30341-1072
Mailing Address - Country:US
Mailing Address - Phone:770-948-3233
Mailing Address - Fax:770-944-1537
Practice Address - Street 1:1668 MULKEY RD STE 164
Practice Address - Street 2:
Practice Address - City:AUSTELL
Practice Address - State:GA
Practice Address - Zip Code:30106-1143
Practice Address - Country:US
Practice Address - Phone:770-948-3233
Practice Address - Fax:770-944-1537
Is Sole Proprietor?:No
Enumeration Date:2006-01-04
Last Update Date:2020-08-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GA045011207RH0003X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RH0003XAllopathic & Osteopathic PhysiciansInternal MedicineHematology & Oncology
Provider Identifiers
StateIdentifier IDID TypeIssuer
GA000781657ACMedicaid
GA000781657ADMedicaid
GACA9328OtherMEDICARE GROUP-DMERC
GA202I902077Medicare PIN
GAF75199Medicare UPIN