Individual
MRS. LEANNE HARRIS MARTINELLI
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA-C
Contact information
Practice address
2745 DEKALB MEDICAL PKWY, SUITE 110, LITHONIA, GA 30058-4932
(770) 981-5431
(770) 981-5515
Mailing address
1835 SAVOY DR, SUITE 300, ATLANTA, GA 30341-1072
(770) 495-3396
(770) 495-2307
Taxonomy
Speciality
Code
Description
License number
State
183500000X
Pharmacist
13486
NC
363AM0700X
Medical Physician Assistant
Primary
004312
GA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
108178463A
—
GA
01
—
CA9328
MEDICARE GROUP-DMERC
GA
Enumeration date
11/13/2006
Last updated
01/13/2011
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