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1114207032
FAIROZ MATJAN RADTKE
SUWANEE, GA
NPI
1114207032
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Entity Type
Individual
Gender
Female
Sole Proprietor ?
No
Primary Taxonomy
363AM0700X Physician Assistant, Medical
(Licence: GA 003766)
Enumeration Date
2011-08-23
Last Update Date
2018-06-26
Business Address
-- FAIROZ MATJAN RADTKE PA-C
5400 LAUREL SPRINGS PKWY SUITE 1401
SUWANEE, GA 30024-6056
Phone number: 678-513-2228
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Mailing Address
-- FAIROZ MATJAN RADTKE PA-C
5850 EUBANK BLVD NE STE B32
ALBUQUERQUE, NM 87111-6127
Phone number: 678-513-2228
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