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Organization
SURGICAL
Active
Organization
SURGICAL
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MS. SARAH GERALD (BILLING MANAGER)
(678) 957-8801
Entity
Organization
Contact information
Practice address
3400 MCCLURE BRIDGE RD, BUILDING B, DULUTH, GA 30096-6675
(678) 957-8801
(678) 990-0176
Mailing address
3400 MCCLURE BRIDGE RD, BUILDING B, DULUTH, GA 30096-6675
(678) 957-8801
(678) 990-0176
Taxonomy
Speciality
Code
Description
License number
State
363AS0400X
Surgical Physician Assistant
Primary
—
NULL
363AS0400X
Surgical Physician Assistant
Primary
—
—
Other
Enumeration date
12/28/2005
Last updated
08/22/2020
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