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Individual

ELIZABETH IJU TAI

Active
Sole proprietor
No

Provider details

NPI number
Gender
F

Contact information

Practice address
2701 NORTH DECATUR ROAD, DECATUR, GA 30033
(404) 501-1849
Mailing address
2100 POWELL STREET, STE 920, EMERYVILLE, CA 94608-1803
(510) 350-2777

Taxonomy

Speciality
Code
Description
License number
State
207P00000X
Emergency Medicine Physician
Primary
047164
GA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
000836954D
GA
05
000836954E
GA
Enumeration date
06/16/2006
Last updated
06/05/2014
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