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Individual

SUMAYAH JAMILA TALIAFERRO

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F
Credential
MD

Contact information

Practice address
3131 MAPLE DR NE, SUITE 102, ATLANTA, GA 30305-2515
(404) 816-7900
(404) 816-7929
Mailing address
PO BOX 52226, ATLANTA, GA 30355-0226
(404) 816-7900
(404) 816-7929

Taxonomy

Speciality
Code
Description
License number
State
174400000X
Specialist
059337
GA
207N00000X
Dermatology Physician
Primary
059337
GA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
059337
STATE LICENSE
Enumeration date
06/26/2007
Last updated
07/01/2011
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