Individual
DR. MARY SULLIVAN NEWELL
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
M.D.
Contact information
Practice address
1365C CLIFTON RD NE, SUITE C1104, ATLANTA, GA 30322-1013
(404) 778-4446
(404) 778-4747
Mailing address
1365C CLIFTON RD NE, ATLANTA, GA 30322-1013
(404) 778-4446
(404) 778-4747
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
050543
GA
2085R0202X
Diagnostic Radiology Physician
Primary
50543
GA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
050543
GA. MED. LICENSE
GA
Enumeration date
07/17/2006
Last updated
06/22/2021
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