Individual
DR. INGRID TANUBRATA
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.D.
Contact information
Practice address
1670 CLAIRMONT RD, DECATUR, GA 30033-4004
(404) 321-6111
Mailing address
10915 OLD STONE CT, DULUTH, GA 30097-8416
(404) 435-6457
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
058227
GA
Other
Enumeration date
07/25/2006
Last updated
10/09/2014
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