Individual
RHEA V DOUGLAS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
P.A.
Contact information
Practice address
1951 CLAIRMONT RD, DECATUR, GA 30033-3415
(404) 321-4600
(404) 320-0987
Mailing address
4285 JOHNS CREEK PKWY, SUITE A, SUWANEE, GA 30024-6038
(770) 622-4412
(770) 622-4191
Taxonomy
Speciality
Code
Description
License number
State
363AM0700X
Medical Physician Assistant
Primary
5536
GA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
202I970522
MEDICARE PTAN
GA
Enumeration date
07/08/2009
Last updated
04/22/2014
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