Individual
MELANIE BANKS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA
Contact information
Practice address
35 COLLIER RD NW, SUITE 635, ATLANTA, GA 30309-1613
(404) 367-3002
Mailing address
PO BOX 102847, ATLANTA, GA 30368-0001
(404) 367-3002
Taxonomy
Speciality
Code
Description
License number
State
363AM0700X
Medical Physician Assistant
Primary
004518
GA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
318665770
—
GA
Enumeration date
05/20/2006
Last updated
10/26/2010
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