Individual
JUAN AYERDI
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Taxonomy
Speciality
Code
Description
License number
State
2086S0129X
Vascular Surgery Physician
Primary
057278
GA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
160318
—
AL
01
—
202I770724
MEDICARE PTAN
GA
05
—
382093991I
—
GA
Enumeration date
12/13/2005
Last updated
11/30/2016
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