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Organization

MARTHA B BOONE M.D. LLC

Active
Organization subpart
No

Provider details

NPI number
Authorized official
DR. MARTHA B BOONE M.D. (OWNER)
(404) 705-8366
Entity
Organization

Contact information

Practice address
3400 OLD MILTON PARKWAY, SUITE A560, ALPHARETTA, GA 30005
(404) 705-8366
(404) 705-8314
Mailing address
3400 OLD MILTON PARKWAY, SUITE A560, ALPHARETTA, GA 30005
(404) 705-8366
(404) 705-8314

Taxonomy

Speciality
Code
Description
License number
State
174400000X
Specialist
042408
GA
208800000X
Urology Physician
Primary
42408
GA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
042408
LICENSE
Enumeration date
08/31/2010
Last updated
02/20/2015
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