| NPI | 1346756129 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | SHELLEY DEPP Payer Relations Liaison 770-579-2626 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207VG0400X Obstetrics & Gynecology Gynecology |
| Enumeration Date | 2017-12-15 |
| Last Update Date | 2017-12-15 |