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Individual

ANISA B THRELKELD

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F
Credential
MD

Contact information

Practice address
980 JOHNSON FY RD NE, SUITE 550, ATLANTA, GA 30342-1626
(404) 631-6440
(404) 631-6332
Mailing address
980 JOHNSON FY RD NE, SUITE 550, ATLANTA, GA 30342-1626
(404) 631-6440
(404) 631-6332

Taxonomy

Speciality
Code
Description
License number
State
207W00000X
Ophthalmology Physician
Primary
38988
GA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
000619077
GA
Enumeration date
08/10/2005
Last updated
06/24/2019
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