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Organization

MAK ANESTHESIA DECATUR LLC

Active
Organization subpart
No

Provider details

NPI number
Authorized official
DR. PAMELA WEIGANDT MD (PRESIDENT)
(770) 702-1806
Entity
Organization

Contact information

Practice address
1457 SCOTT BLVD, DECATUR, GA 30030-1425
(404) 292-2500
Mailing address
1635 OLD 41 HIGHWAY NW, SUITE 112-328, KENNESAW, GA 30152
(770) 702-1806
(770) 693-0810

Taxonomy

Speciality
Code
Description
License number
State
207L00000X
Anesthesiology Physician
Primary
51609
GA

Other

Enumeration date
01/02/2014
Last updated
11/01/2016
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