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Individual

GLORIA CHAFFIN

Active
Sole proprietor
No

Provider details

NPI number
Gender
F

Contact information

Practice address
677 CHURCH ST NE, MARIETTA, GA 30060-1101
(770) 794-0477
(770) 794-3108
Mailing address
4922 STARVILLE RD, CHINA, MI 48054-3021
(404) 210-5504

Taxonomy

Speciality
Code
Description
License number
State
367H00000X
Anesthesiologist Assistant
Primary
67.000341
OH
367H00000X
Anesthesiologist Assistant
GA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
0853956
BCBS MI PIN
Enumeration date
07/29/2007
Last updated
12/07/2022
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