Individual
DR. AMANDA DAVIS HERIN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.D.
Contact information
Practice address
1412 MILSTEAD AVE NE, CONYERS, GA 30012-3877
(770) 918-3000
Mailing address
PO BOX 102321, ATLANTA, GA 30368-2321
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
050152
GA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
000919366D
—
GA
Enumeration date
06/23/2006
Last updated
07/12/2021
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