Individual
DR. CHERI OWENS VACHTSEVANOS
Active
Sole proprietor
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
667 LANIER PARK DR, GAINESVILLE, GA 30501-2059
(770) 532-7501
(770) 532-8322
Mailing address
667 LANIER PARK DR, GAINESVILLE, GA 30501-2059
(770) 532-7501
(770) 532-8322
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
047817
GA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
00903515A
—
GA
01
—
208354
BLUE CROSS BLUE SHIELD
GA
01
—
P00136139
RAILROAD MEDICARE
GA
Enumeration date
03/10/2006
Last updated
07/08/2007
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