Individual
MIRIAM P GENTIN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.D.
Contact information
Practice address
4035 JOHNS CREEK PKWY STE C, SUWANEE, GA 30024-1213
(678) 450-0202
(678) 971-6065
Mailing address
663 LANIER PARK DR, GAINESVILLE, GA 30501-2059
(678) 450-0202
(678) 450-0080
Taxonomy
Speciality
Code
Description
License number
State
207RN0300X
Nephrology Physician
Primary
53311
GA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
363219785C
—
GA
Enumeration date
05/23/2005
Last updated
01/16/2019
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