Individual
DR. MICAH R. TEPPER
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
1700 HOSPITAL SOUTH DR, SUITE 409, AUSTELL, GA 30106-6810
(770) 732-9100
(678) 819-0360
Mailing address
55 WHITCHER ST NE, SUITE 350, MARIETTA, GA 30060-1155
(770) 424-6893
(678) 819-0360
Taxonomy
Speciality
Code
Description
License number
State
207RC0000X
Cardiovascular Disease Physician
Primary
057687
GA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
186998965J
—
GA
05
—
186998965K
—
GA
05
—
186998965L
—
GA
05
—
186998965M
—
GA
Enumeration date
05/25/2006
Last updated
12/02/2019
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