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Individual

MR. RICHARD GEORGE BROUILLARD

Active
Sole proprietor

Provider details

NPI number
Gender
Man
Credential
PAAA

Contact information

Practice address
1364 CLIFTON RD NE, ATLANTA, GA 30322-1059
(404) 778-3900
(404) 778-5194
Mailing address
784 CRESTRIDGE DR NE, ATLANTA, GA 30306-3621
(404) 872-0653
(404) 778-5194

Taxonomy

Speciality
Code
Description
License number
State
367H00000X
Anesthesiologist Assistant
Primary
000961
GA

Other

Enumeration date
06/24/2006
Last updated
07/08/2007
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