Individual
DR. KEREN AVIVA BASHAN-GILZENRAT
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.D.
Contact information
Practice address
55 WHITCHER ST NE STE 130, MARIETTA, GA 30060
(770) 426-1629
(770) 427-8001
Mailing address
805 SANDY PLAINS ROAD, MEDICAL STAFF SERVICES, MARIETTA, GA 30066-6340
Taxonomy
Speciality
Code
Description
License number
State
2086S0127X
Trauma Surgery Physician
Primary
070045
GA
390200000X
Student in an Organized Health Care Education/Training Program
2014-01249
NC
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Enumeration date
06/22/2008
Last updated
10/16/2019
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