Individual
XAVIER AMPUERO DURALDE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
2045 PEACHTREE RD NE, SUITE 700, ATLANTA, GA 30309-1414
(404) 355-0743
(404) 603-9887
Mailing address
2001 PEACHTREE RD NE, SUITE 705, ATLANTA, GA 30309-1476
(404) 355-0743
(404) 355-2136
Taxonomy
Speciality
Code
Description
License number
State
207X00000X
Orthopaedic Surgery Physician
036722
GA
207XX0005X
Sports Medicine (Orthopaedic Surgery) Physician
Primary
036722
GA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
00544585A
—
GA
Enumeration date
08/10/2005
Last updated
02/24/2010
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