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Individual

JESSICA BISTAFA LIU

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
MD

Contact information

Practice address
5673 PEACHTREE DUNWOODY RD STE 500, ATLANTA, GA 30342-2147
(404) 778-7402
Mailing address
PO BOX 102632, ATLANTA, GA 30368-2632
(404) 778-7402

Taxonomy

Speciality
Code
Description
License number
State
207RG0300X
Geriatric Medicine (Internal Medicine) Physician
Primary
100031
GA
390200000X
Student in an Organized Health Care Education/Training Program
MA

Other

Enumeration date
04/16/2019
Last updated
05/28/2024
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