Individual
MISS GERREN ECTOR
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.D
Contact information
Practice address
193 N PARK TRL, SUITE 100, STOCKBRIDGE, GA 30281-7373
(770) 389-0116
Mailing address
193 N PARK TRL, SUITE 100, STOCKBRIDGE, GA 30281-7373
(770) 389-0116
Taxonomy
Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
Primary
69581
GA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
003133545A
—
GA
01
—
69581
STATE LICENSE
GA
Enumeration date
06/11/2010
Last updated
03/07/2023
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