| NPI | 1558803486 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MICHELLE SCHWEI Director Of Credentialing 770-518-4406 |
| Organization Subpart ? | No |
| Primary Taxonomy | 363AM0700X Physician Assistant, Medical (Licence: GA 8199) |
| Enumeration Date | 2016-11-09 |
| Last Update Date | 2024-08-08 |