Individual
DR. MALIA DOLORES WILLIS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.D.
Contact information
Practice address
550 PEACHTREE ST NE, ATLANTA, GA 30308
(404) 686-4411
Mailing address
550 PEACHTREE ST NE, ATLANTA, GA 30308-2245
(404) 686-4411
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
82794
GA
208D00000X
General Practice Physician
57366
TN
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Enumeration date
04/24/2015
Last updated
06/13/2019
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