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Individual

MICHAEL W. HURST

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
PAAA

Contact information

Practice address
2550 WINDY HILL RD SE, SUITE 302, MARIETTA, GA 30067-8665
(678) 574-0943
(678) 574-0943
Mailing address
3155 N POINT PKWY, ATTN: CREDENTIALING DEPT, BUILDING F, SUITE 100, ALPHARETTA, GA 30005
(770) 645-9181
(770) 645-8455

Taxonomy

Speciality
Code
Description
License number
State
367H00000X
Anesthesiologist Assistant
Primary
2564
GA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
100002545D
GA
Enumeration date
10/12/2005
Last updated
09/18/2008
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