Individual
DR. JONATHAN MICIELI
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
1365B CLIFTON RD NE, ATLANTA, GA 30322-1013
(404) 778-5128
(404) 778-5128
Mailing address
407 SUMMIT POINTE WAY NE, ATLANTA, GA 30329-4059
Taxonomy
Speciality
Code
Description
License number
State
207W00000X
Ophthalmology Physician
Primary
77690
GA
Other
Enumeration date
07/25/2017
Last updated
07/25/2017
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