Individual
JUAN CARLOS CADAVID SEPULVEDA
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD.
Contact information
Practice address
1505 NORTHSIDE BLVD STE 3500, CUMMING, GA 30041-8223
(770) 292-3120
(770) 292-3121
Mailing address
1505 NORTHSIDE BLVD STE 3500, CUMMING, GA 30041-8223
(770) 292-3120
(770) 292-3121
Taxonomy
Speciality
Code
Description
License number
State
207RC0200X
Critical Care Medicine (Internal Medicine) Physician
068126
GA
207RP1001X
Pulmonary Disease Physician
Primary
068126
GA
207RP1001X
Pulmonary Disease Physician
MD 438781
PA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
003126963B
—
GA
Enumeration date
05/11/2007
Last updated
05/08/2021
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