Individual
SUZANA MARA MONTANA
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.D.
Contact information
Practice address
3780 HOLCOMB BRIDGE RD, STE C, PEACHTREE CORNERS, GA 30092-2701
(770) 263-9101
(770) 263-9102
Mailing address
3780 HOLCOMB BRIDGE RD, STE C, PEACHTREE CORNERS, GA 30092-2701
(770) 263-9101
(770) 263-9102
Taxonomy
Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
Primary
045097
GA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
000773209U
—
GA
Enumeration date
05/05/2006
Last updated
05/05/2015
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