Individual
WALTER JORGE ASTORNE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD, FACP
Contact information
Practice address
55 WHITCHER ST NE STE 160, MARIETTA, GA 30060-1160
(770) 422-1372
(770) 423-9651
Mailing address
55 WHITCHER ST NE STE 160, MARIETTA, GA 30060-1160
(770) 422-1372
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
4301085400
MI
207RC0200X
Critical Care Medicine (Internal Medicine) Physician
Primary
081562
GA
207RC0200X
Critical Care Medicine (Internal Medicine) Physician
52149
MN
207RN0300X
Nephrology Physician
104428
MN
207RN0300X
Nephrology Physician
52149
MN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
ENROLLED
—
MN
Enumeration date
05/22/2007
Last updated
09/27/2019
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