Individual
MARISSA M GANS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA-C
Contact information
Practice address
5671 PEACHTREE DUNWOODY RD STE 900, ATLANTA, GA 30342-5022
(404) 847-9999
(404) 531-8466
Mailing address
5671 PEACHTREE DUNWOODY RD STE 900, ATLANTA, GA 30342-5022
(404) 847-9999
(404) 531-8466
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
10132
GA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
15021462
CAQH NUMBER
—
Enumeration date
11/11/2020
Last updated
11/18/2024
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