Individual
CAMERON MEDINA
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PA-C
Contact information
Practice address
705 DIXIE ST, CARROLLTON, GA 30117-3818
(770) 836-9666
Mailing address
103 HIDDEN LAKE DR, BREMEN, GA 30110-7910
(770) 842-1330
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
8408
GA
Other
Enumeration date
08/22/2017
Last updated
08/22/2017
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