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Individual

PAOLA JULIANA SUAREZ

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
M.D.

Contact information

Practice address
220 OAKSIDE LN, CANTON, GA 30114-6413
(678) 807-1050
(678) 807-1055
Mailing address
260 ELM ST, CUMMING, GA 30040-2467
(770) 887-1668
(770) 887-3462

Taxonomy

Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
19949
MS
208000000X
Pediatrics Physician
Primary
67096
GA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
00313120097
GA
05
300022400A
GA
01
C02394
MEDICARE GROUP
MS
Enumeration date
12/10/2007
Last updated
07/01/2014
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