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Individual

DR. VANCHAD C MEMARK

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
M.D.

Contact information

Practice address
148 BILL CARRUTH PKWY, SUITE 180, HIRAM, GA 30141-3754
(770) 445-4915
(770) 445-2876
Mailing address
148 BILL CARRUTH PKWY, SUITE 180, HIRAM, GA 30141-3754
(770) 445-4915
(770) 445-2876

Taxonomy

Speciality
Code
Description
License number
State
208600000X
Surgery Physician
Primary
64416
GA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
2949877
OH
Enumeration date
11/01/2007
Last updated
01/30/2017
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