Individual
TANAYA YIDIN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA-C
Contact information
Practice address
285 BOULEVARD NE STE 415, ATLANTA, GA 30312-4210
(404) 265-4400
(404) 265-4452
Mailing address
285 BOULEVARD NE STE 415, ATLANTA, GA 30312-4210
(404) 265-4400
(404) 265-4452
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
9546
GA
363A00000X
Physician Assistant
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
305597
PA TEMP LICENSE
LA
Enumeration date
06/26/2017
Last updated
07/21/2022
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