Individual
WILLIBROAD LOFON MAIMO
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
5671 PEACHTREE DUNWOODY RD, ATLANTA, GA 30342-5000
(404) 778-6070
Mailing address
101 WOODRUFF CIRCLE WMB 319, ATLANTA, GA 30332-0147
Taxonomy
Speciality
Code
Description
License number
State
207RC0000X
Cardiovascular Disease Physician
Primary
101624
GA
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Enumeration date
06/27/2017
Last updated
09/06/2024
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