Individual
MR. CHARLES DANIEL KERVIN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
AA-C
Contact information
Practice address
80 JESSE HILL JR DR SE, ANESTHESIA DEPT., ATLANTA, GA 30303-3031
(404) 616-5519
Mailing address
80 JESSE HILL JR DR SE, ANESTHESIA DEPT., ATLANTA, GA 30303-3031
(404) 616-5519
Taxonomy
Speciality
Code
Description
License number
State
367H00000X
Anesthesiologist Assistant
Primary
2342
GA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
AA0005
—
SC
05
—
GP2991
—
SC
Enumeration date
12/01/2005
Last updated
03/16/2010
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