Individual
MR. WINSTON DOUGLAS II
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
677 CHURCH ST NE, MARIETTA, GA 30060-1101
(770) 422-2326
Mailing address
677 CHURCH ST NE STE 100N, MARIETTA, GA 30060-1101
(770) 422-2326
Taxonomy
Speciality
Code
Description
License number
State
363LA2100X
Acute Care Nurse Practitioner
Primary
RN216043
GA
Other
Enumeration date
03/03/2020
Last updated
03/03/2020
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