Individual
TIFFANY COLARUSSO
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
M.D.
Contact information
Practice address
1015 DONALD LEE HOLLOWELL PKWY NW, ATLANTA, GA 30318-6653
(404) 523-6571
Mailing address
9111 OLD MILL ST, LITHIA SPRINGS, GA 30122-6415
(404) 861-6315
Taxonomy
Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
Primary
053146
GA
208000000X
Pediatrics Physician
L9447
TX
Other
Enumeration date
02/22/2009
Last updated
02/22/2009
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