Individual
MARY MCLAIN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
550 PEACHTREE ST NE, ATLANTA, GA 30308-2212
(470) 992-3658
(470) 264-7038
Mailing address
PO BOX 371795, DECATUR, GA 30037-1795
(470) 992-3658
(470) 264-7038
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
035931
GA
363L00000X
Nurse Practitioner
Primary
LPN035931
GA
363L00000X
Nurse Practitioner
RN035931
GA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1609536549
NPPES
—
Enumeration date
07/23/2022
Last updated
08/29/2023
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