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Individual

ANTIQUA WALKER

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
F

Contact information

Practice address
2751 BUFORD HWY NE STE 700, ATLANTA, GA 30324-5510
(877) 839-3988
Mailing address
2751 BUFORD HWY NE STE 700, ATLANTA, GA 30324-5510
(404) 520-2492

Taxonomy

Speciality
Code
Description
License number
State
247ZC0005X
Clinical Laboratory Director (Non-physician)
Primary
11D2240079
GA
302R00000X
Health Maintenance Organization
GA

Other

Enumeration date
02/02/2022
Last updated
02/09/2023
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