is a Surgical in Cumming, Georgia. practices all healthcare services and medical treatments related to Surgical. The NPI Number for is 1104937317. The last update date is .
's current location address is 1505 Northside Blvd, Cumming, Georgia. You can contact this provider via phone number 7702923490 and fax number 4048516283. The mailing address for is 1505 Northside Blvd, Cumming, Georgia. To know further, please read the information below!
Provider Profile Detail
Provider Name | |
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Address | 1505 Northside Blvd, Cumming, Georgia |
Phone Number | 7702923490 |
Fax Number | 4048516283 |
Sole Proprietor | -- |
Credentials | -- |
NPI Number Detail
NPI Number | 1104937317 |
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Provider Enumeration Date | |
Last Updated Date |
Provider Mailing Address Detail
Address | 1505 Northside Blvd |
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City | Cumming |
State | Georgia (GA) |
Post Code | 300417623 |
Phone Number | 7702923490 |
Fax Number | 4048516283 |
Provider's Primary Taxonomy Detail
Speciality | Surgical |
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Taxonomy | 363As0400X |
Licence No | 2106 |
Definition: A licensed healthcare professional who assists in providing surgical care under physician supervision. |
Provider's Other Legacy Identifiers
Identifier | Identifier Type | Identifier State | Identifier Issuer |
---|---|---|---|
003119970D | GA | -- | |
003119970B | GA | -- | |
003119970C | GA | -- |
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