Individual
MR. BLAINE JOSPEH WALSH
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PA-C
Contact information
Practice address
275 COLLIER RD NW STE 300, ATLANTA, GA 30309-1740
(404) 350-0009
Mailing address
2727 PACES FERRY RD SE STE 1-1100, ATLANTA, GA 30339-6151
(470) 271-3418
Taxonomy
Speciality
Code
Description
License number
State
363AM0700X
Medical Physician Assistant
Primary
009088
GA
Other
Enumeration date
10/24/2018
Last updated
01/16/2019
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