Individual
WILMA REBECA ORELLANA PHADKE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
M.D.
Contact information
Practice address
1001 JOHNSON FY RD NE, SRPAC (GPS), ATLANTA, GA 30342-1605
(404) 785-2338
Mailing address
1001 JOHNSON FY RD NE, SRPAC GPS, ATLANTA, GA 30342-1605
Taxonomy
Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
Primary
74593
GA
390200000X
Student in an Organized Health Care Education/Training Program
4301098965
MI
Other
Enumeration date
07/19/2011
Last updated
09/29/2023
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