Organization
MICROMED LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
THERESA WANG (PRESIDENT)
(917) 991-0319
Entity
Organization
Contact information
Practice address
1266 W PACES FERRY RD NW STE 231, ATLANTA, GA 30327-2306
(917) 991-0319
Mailing address
1266 W PACES FERRY RD NW STE 231, ATLANTA, GA 30327-2306
(917) 991-0319
Taxonomy
Speciality
Code
Description
License number
State
2086S0122X
Plastic and Reconstructive Surgery Physician
Primary
—
—
Other
Enumeration date
02/25/2020
Last updated
02/25/2020
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