Individual
DR. GLENN BLAISE GATIPON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
MD PHD MBA
Contact information
Practice address
888 OLD MOUNTAIN RD NW, KENNESAW, GA 30152-3843
(770) 426-0102
Mailing address
400 TOWER RD NE STE 150, MARIETTA, GA 30060-9416
(678) 581-5252
Taxonomy
Speciality
Code
Description
License number
State
207RB0002X
Obesity Medicine (Internal Medicine) Physician
Primary
23962
GA
Other
Enumeration date
07/15/2013
Last updated
04/29/2020
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