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Individual

ERIK BAUTISTA

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
PHARMD

Contact information

Practice address
1001 JOHNSON FY RD NE, ATLANTA, GA 30342-1605
(404) 785-2059
Mailing address
1001 JOHNSON FY RD NE, ATLANTA, GA 30342-1605
(404) 785-2059

Taxonomy

Speciality
Code
Description
License number
State
183500000X
Pharmacist
Primary
19060
GA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
REF000000374
GA
Enumeration date
04/24/2020
Last updated
04/24/2020
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