Individual
DR. DONALD RUBERTINO POWELL
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DPM
Contact information
Practice address
550 PEACHTREE ST NE, STE 1615, ATLANTA, GA 30308-2212
(678) 702-0620
(678) 702-0621
Mailing address
1975 HIGHWAY 54 W, SUITE 205, PEACHTREE CITY, GA 30269-4794
(678) 561-9000
(770) 487-1232
Taxonomy
Speciality
Code
Description
License number
State
213ES0103X
Foot & Ankle Surgery Podiatrist
PO3482
FL
213ES0103X
Foot & Ankle Surgery Podiatrist
Primary
POD00135
GA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
003131663A
—
GA
05
—
003131663B
—
GA
05
—
003131663C
—
GA
01
—
202I487348
MEDICARE PTAN
GA
Enumeration date
02/01/2011
Last updated
12/03/2015
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