Individual
ERNEST EBUN COKER
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
601A PROFESSIONAL DRIVE, SUITE 180, LAWRENCEVILLE, GA 30046
(770) 822-4120
(770) 822-2830
Mailing address
601A PROFESSIONAL DRIVE, SUITE 180, LAWRENCEVILLE, GA 30046
(770) 822-4120
(770) 822-2830
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
040349
GA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
000740671D
—
GA
01
—
52727251
BLUE CROSS BLUE SHIELD
GA
Enumeration date
01/31/2006
Last updated
10/01/2014
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