Individual
WILLIAM A. MARBURY
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PAA
Contact information
Practice address
303 PARKWAY DR NE, ATLANTA, GA 30312-1212
(404) 265-4520
(404) 265-3894
Mailing address
3955 CHIMNEY RIDGE CT, ELLENWOOD, GA 30294-1446
(404) 849-9450
Taxonomy
Speciality
Code
Description
License number
State
363AM0700X
Medical Physician Assistant
004644
GA
367H00000X
Anesthesiologist Assistant
Primary
004644
GA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
782557551A
—
GA
05
—
782557551B
—
GA
05
—
782557551C
—
GA
01
—
N345536
WELLCARE
GA
01
—
P00301548
RAILROAD MEDICARE
—
Enumeration date
05/11/2006
Last updated
09/03/2020
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