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Individual

DR. EDWIN H. DONNELLY

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
M.D.

Contact information

Practice address
975 JOHNSON FERRY RD NE, SUITE 370, ATLANTA, GA 30342-1619
(404) 250-1242
(404) 250-1232
Mailing address
975 JOHNSON FERRY RD NE, SUITE 370, ATLANTA, GA 30342-1619
(404) 250-1242
(404) 250-1232

Taxonomy

Speciality
Code
Description
License number
State
207W00000X
Ophthalmology Physician
019156
GA
207WX0107X
Retina Specialist (Ophthalmology) Physician
Primary
019156
GA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
00154206B
GA
01
581425151
TAX ID
GA
Enumeration date
06/13/2005
Last updated
10/04/2017
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