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Individual

MARCUS J GATES

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
MD

Contact information

Practice address
1700 HOSPITAL SOUTH DR STE 102, AUSTELL, GA 30106-8116
(470) 956-4410
(770) 745-0782
Mailing address
1700 HOSPITAL SOUTH DR STE 102, AUSTELL, GA 30106-8116
(470) 956-4410
(707) 450-7827

Taxonomy

Speciality
Code
Description
License number
State
207T00000X
Neurological Surgery Physician
56552
MN
207T00000X
Neurological Surgery Physician
Primary
82595
GA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
ENROLLED
IA
05
ENROLLED
MN
Enumeration date
06/20/2012
Last updated
03/02/2020
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