Individual
MARISSA NICOLLE BALKCOM
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
2220 N DRUID HILLS RD NE, ATLANTA, GA 30329-3117
(404) 712-9677
Mailing address
3070 BRIARCLIFF RD NE APT 2315, ATLANTA, GA 30329-2759
(770) 337-9602
Taxonomy
Speciality
Code
Description
License number
State
390200000X
Student in an Organized Health Care Education/Training Program
Primary
—
—
Other
Enumeration date
03/28/2022
Last updated
06/21/2025
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