Individual
MR. MAURICIO ANDRES MEDINA MIELES
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
800 GI MADDOX PARKWAY, CHATSWORTH, GA 30705
(706) 686-8015
(706) 686-8221
Mailing address
1200 MEMORIAL DRIVE, DALTON, GA 30720
(706) 226-8996
(706) 272-6761
Taxonomy
Speciality
Code
Description
License number
State
390200000X
Student in an Organized Health Care Education/Training Program
Primary
16884
GA
390200000X
Student in an Organized Health Care Education/Training Program
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—
Other
Enumeration date
04/03/2024
Last updated
09/27/2024
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