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Individual

HEATHER ROSE VAN DUYS

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
PA-C

Contact information

Practice address
550 PEACHTREE ST NE STE 1600, ATLANTA, GA 30308-2246
(404) 881-1094
(404) 874-1249
Mailing address
1001 SUMMIT BLVD STE 200, BROOKHAVEN, GA 30319-6410
(770) 989-1668
(678) 388-1759

Taxonomy

Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
IL
363AM0700X
Medical Physician Assistant
Primary
GA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
003188490B
GA
Enumeration date
09/24/2013
Last updated
10/05/2018
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