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Individual

FAULL SANDERS TROVER

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
M.D.

Contact information

Practice address
4155 BAKER ST NE, COVINGTON, GA 30014-1405
(770) 787-4122
(770) 787-4655
Mailing address
4155 BAKER ST NE, COVINGTON, GA 30014-1405
(770) 787-4122
(770) 787-4655

Taxonomy

Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
Primary
042750
GA

Other

Enumeration date
08/10/2005
Last updated
07/08/2007
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