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Individual

MR. NINO RENZO RENZO FORNASINI

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
MD

Contact information

Practice address
3985 STEVE REYNOLDS BLVD, BLDG I, NORCROSS, GA 30093-3035
(770) 622-3948
(770) 622-4879
Mailing address
3985 STEVE REYNOLDS BLVD, BLDG I, NORCROSS, GA 30093-3035
(770) 622-3948
(770) 622-4879

Taxonomy

Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
Primary
48628
GA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
000879755A
GA
Enumeration date
11/20/2006
Last updated
07/19/2021
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