Organization
PLASTIC AND RECONSTRUCTIVE SURGERY OF ATLANTA
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. THERESA WANG M.D. (OWNER)
(917) 991-0319
Entity
Organization
Contact information
Practice address
1218 W PACES FERRY RD NW, ATLANTA, GA 30327-2308
(917) 991-0319
(718) 672-3280
Mailing address
2795 PEACHTREE RD NE, UNIT 309, ATLANTA, GA 30305-3611
(917) 991-0319
(718) 672-3280
Taxonomy
Speciality
Code
Description
License number
State
2086S0122X
Plastic and Reconstructive Surgery Physician
Primary
070000
GA
Other
Enumeration date
06/28/2013
Last updated
02/07/2014
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