Individual
CHARLOTTE ANNE MASSAD
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
5445 MERIDIAN MARKS RD NE, SUITE 420, ATLANTA, GA 30342-4763
(404) 252-5206
(404) 252-1268
Mailing address
2800 SCENIC DRIVE, SUITE 4 BOX 77, BLUE RIDGE, GA 30513
(404) 353-4137
(678) 284-4076
Taxonomy
Speciality
Code
Description
License number
State
2088P0231X
Pediatric Urology Physician
Primary
026793
GA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
000457674A
—
GA
01
—
340019506
RAILROAD MEDICARE
GA
05
—
Q26793
—
SC
Enumeration date
09/12/2006
Last updated
03/07/2023
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