Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.
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Mariam K. Ishaq, PA-C

Individual provider Physician Assistant · NPI 1639985245

Mariam K. Ishaq, PA-C is a Physician Assistant in Canton, Georgia. Graduated from Mercer University School of Medicine in 2024, 2 years ago. Practices with Northside Cardiovascular Professional Services, LLC, a 142-clinician group and accepts Medicare assignment. Licensed in Georgia.

Years since qualifying
2
Trained at
Mercer University School of Medicine
Licensed in
GA
In the registry since
2024
What do these letters mean?
PA-C — Physician Assistant, Certified
A physician assistant who holds current national certification.

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Practice location Address checks out

470 Northside Cherokee Blvd Ste 480
Canton, GA 30115-8034
Phone: (404) 845-8200
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Physician Assistant (primary) Taxonomy 363A00000X · Licence 12436 (GA)

Record details

NPI number1639985245
Entity typeIndividual (Type 1)
GenderFemale
Credentials PA-C
Sole proprietorNo
NPI enumeratedDecember 9, 2024
Last updated in NPPESMarch 2, 2025
Certification dateMarch 2, 2025

Medicare enrollment

From the CMS Doctors & Clinicians file — this clinician is enrolled in Medicare.

Medicare specialtyPHYSICIAN ASSISTANT
Medical schoolMERCER UNIVERSITY SCHOOL OF MEDICINE
Graduated 2024 (2 years in practice)
Group practice Northside Cardiovascular Professional Services, Llc — 142 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount
Practice locations2 on file with Medicare

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