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Individual

DR. NICOLE B PETCHENIK

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
M.D.

Contact information

Practice address
4360 CHAMBLEE DUNWOODY RD, SUITE 370, ATLANTA, GA 30341-1049
(770) 399-5055
(770) 399-9638
Mailing address
4360 CHAMBLEE DUNWOODY RD, SUITE 370, ATLANTA, GA 30341-1049
(770) 399-5055
(770) 399-9638

Taxonomy

Speciality
Code
Description
License number
State
207V00000X
Obstetrics & Gynecology Physician
Primary
063116
GA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
589407380B
GA
05
589407380C
GA
05
589407380F
GA
Enumeration date
02/21/2007
Last updated
09/12/2014
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