Individual
DR. CAMILLE ATALLAH
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
1058 BERMUDA RUN ROAD, STATESBORO, GA 30458
(912) 871-7100
(912) 871-7110
Mailing address
PO BOX 1639, STATESBORO, GA 30459-1639
(912) 871-7100
(912) 871-7110
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
047289
GA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
00827681B
—
GA
01
—
020052432
RAILROAD MEDICARE
GA
01
—
582449176
CEDAR SURGICAL ASSOCIATES
GA
Enumeration date
11/01/2006
Last updated
07/08/2007
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