Individual
DR. GERALDO ENRIQUE HOLGUIN TERRERO
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
1412 MILSTEAD AVE NE, CONYERS, GA 30012-3877
(404) 350-0009
(404) 350-0280
Mailing address
PO BOX 102847, ATLANTA, GA 30368-2847
(770) 801-2500
Taxonomy
Speciality
Code
Description
License number
State
207RP1001X
Pulmonary Disease Physician
54325
TN
207RP1001X
Pulmonary Disease Physician
Primary
79228
GA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
698866
MEDICAID MANAGEMENT INFORMATION SYSTEM
NY
Enumeration date
11/20/2010
Last updated
03/22/2021
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