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Individual

GILLIAN A CARPENTER

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
MD

Contact information

Practice address
5732 NEWBERRY POINT DR, FLOWERY BRANCH, GA 30542-2754
(770) 561-5131
Mailing address
5732 NEWBERRY POINT DR, FLOWERY BRANCH, GA 30542-2754
(770) 561-5131

Taxonomy

Speciality
Code
Description
License number
State
2080P0202X
Pediatric Cardiology Physician
051301
GA
208D00000X
General Practice Physician
Primary
053101
GA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
000973398B
GA
Enumeration date
05/09/2006
Last updated
06/25/2021
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