Individual
EBONIQUE C PILLOT MAGEE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA-C
Contact information
Practice address
5910 HILLANDALE DR STE 301, LITHONIA, GA 30058-1880
(707) 987-2155
Mailing address
2024 BRIAR CREEK CT NE, CONYERS, GA 30012-7123
(404) 421-6966
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
004500
GA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
758372220A
—
GA
05
—
758372220B
—
GA
05
—
758372220C
—
GA
05
—
758372220D
—
GA
05
—
758372220E
—
GA
Enumeration date
07/01/2006
Last updated
11/06/2020
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