Individual
MARC I. UNTERMAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
766 WALTHER RD, SUITE 100, LAWRENCEVILLE, GA 30046-8764
(678) 312-9100
(678) 312-9101
Mailing address
766 WALTHER RD, SUITE 100, LAWRENCEVILLE, GA 30046-8764
(678) 312-9100
(678) 312-9101
Taxonomy
Speciality
Code
Description
License number
State
207RC0000X
Cardiovascular Disease Physician
Primary
19800
GA
207RI0011X
Interventional Cardiology Physician
19800
GA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
00170607D
—
GA
Enumeration date
09/21/2005
Last updated
06/28/2013
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