Individual
DR. WILLIAM ANGELO PRIMOS JR.
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
108 PROMINENCE CT STE 200, DAWSONVILLE, GA 30534-6340
(770) 848-6190
Mailing address
PO BOX 742616, ATLANTA, GA 30374-2616
(770) 219-8420
Taxonomy
Speciality
Code
Description
License number
State
2080S0010X
Pediatric Sports Medicine Physician
39336
NC
2080S0010X
Pediatric Sports Medicine Physician
Primary
42395
GA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
813658737A
—
GA
05
—
8969208
—
NC
05
—
N39665
—
SC
Enumeration date
11/16/2005
Last updated
10/16/2020
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