Organization
MAK ANESTHESIA, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. PAMELA WEIGANDT M.D. (PRESIDENT AND CEO)
(770) 702-1806
Entity
Organization
Contact information
Practice address
1621 N ROBERTS RD NW STE 110, KENNESAW, GA 30144-3640
(770) 702-1806
Mailing address
1635 OLD 41 HWY NW STE 112-328, KENNESAW, GA 30152-4480
(770) 702-1806
Taxonomy
Speciality
Code
Description
License number
State
207L00000X
Anesthesiology Physician
Primary
OCC003663
GA
Other
Enumeration date
07/16/2015
Last updated
07/16/2015
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