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Individual

DR. TRENT SKAAR TADSEN

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
MD

Contact information

Practice address
1225 LAMBETH WAY SE, CONYERS, GA 30013-1756
(770) 388-7068
Mailing address
1225 LAMBETH WAY SE, CONYERS, GA 30013-1756
(770) 388-7068

Taxonomy

Speciality
Code
Description
License number
State
207L00000X
Anesthesiology Physician
Primary
02767
GA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
52043702-008
BLUE CROSS BLUE SHIELD
GA
Enumeration date
01/25/2006
Last updated
10/08/2007
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