Organization
MAK ANESTHESIA WESTSIDE LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
PAMELA A WEIGANDT MD (PRESIDENT)
(770) 702-1806
Entity
Organization
Contact information
Practice address
1269 WELLBROOK CIR NE, CONYERS, GA 30012-3873
(770) 922-0505
(770) 922-1870
Mailing address
1635 OLD 41 HIGHWAY NW, SUITE 112-328, KENNESAW, GA 30152
(770) 702-1806
(770) 693-0810
Taxonomy
Speciality
Code
Description
License number
State
207L00000X
Anesthesiology Physician
Primary
—
—
Other
Enumeration date
01/12/2012
Last updated
11/01/2016
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