Individual
MS. JUAQUITA D CALLAWAY
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
2785 LAWRENCEVILLE HWY, STE 107, DECATUR, GA 30033
(678) 205-0405
Mailing address
2785 LAWRENCEVILLE HWY, STE 107, DECATUR, GA 30033
(678) 205-0405
Taxonomy
Speciality
Code
Description
License number
State
207VG0400X
Gynecology Physician
Primary
033289
GA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
000532749A
—
GA
Enumeration date
07/07/2005
Last updated
06/07/2013
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