Individual
SUSAN ANDREA MULLIGAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.D.
Contact information
Practice address
975 JOHNSON FERRY RD NE, SUITE 500, ATLANTA, GA 30342-4737
(404) 255-8086
Mailing address
975 JOHNSON FERRY RD NE, SUITE 500, ATLANTA, GA 30342-4737
(404) 255-8086
Taxonomy
Speciality
Code
Description
License number
State
2085R0202X
Diagnostic Radiology Physician
12425
AL
2085R0202X
Diagnostic Radiology Physician
Primary
58084
GA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
300015346
RAILROAD MEDICARE
AL
01
—
51521668
BLUE CROSS/BLUE SHIELD
AL
01
—
51521669
BLUE CROSS/BLUE SHIELD
AL
05
—
748293523A
—
GA
Enumeration date
04/10/2006
Last updated
08/12/2013
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