Individual
MIKO DE BRUYN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
49 JESSE HILL JR DR SE, ATLANTA, GA 30303-3049
(404) 616-1000
Mailing address
49 JESSE HILL JR DR SE, ATLANTA, GA 30303-3049
(404) 727-5655
(404) 727-0045
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
13081
GA
Other
Enumeration date
08/17/2018
Last updated
04/03/2024
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