Individual
DR. VIKTOR BOUQUETTE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
4646 N. SHALLOWFORD ROAD, ATLANTA, GA 30338
(770) 676-6000
(770) 392-9805
Mailing address
4646 N. SHALLOWFORD ROAD, ATLANTA, GA 30338
(770) 676-6000
(770) 392-9805
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
026769
GA
Other
Enumeration date
04/19/2007
Last updated
07/08/2007
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