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Organization

NICHOLAS A PIETRZAK, MD, LLC

Active
Organization subpart
No

Provider details

NPI number
Authorized official
MRS. KIM COOK (OFFICE ADMINISTRATOR)
(478) 757-1934
Entity
Organization

Contact information

Practice address
3951 RIDGE AVE, STE B, MACON, GA 31210-5050
(478) 757-1934
(478) 757-1596
Mailing address
3951 RIDGE AVE, STE B, MACON, GA 31210-5050
(478) 757-1934
(478) 757-1596

Taxonomy

Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
044308
GA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
00834413D
GA
Enumeration date
06/11/2007
Last updated
06/07/2010
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