Organization
GINPEN, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. ANGELA SWAYNE MD (MANAGER)
(770) 714-4643
Entity
Organization
Contact information
Practice address
238 OLD NORTON RD, FAYETTEVILLE, GA 30215-4921
(770) 714-4643
Mailing address
238 OLD NORTON RD, FAYETTEVILLE, GA 30215-4921
Taxonomy
Speciality
Code
Description
License number
State
207RH0002X
Hospice and Palliative Medicine (Internal Medicine) Physician
Primary
053421
GA
Other
Enumeration date
09/20/2010
Last updated
09/20/2010
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