Individual
DR. TATYANA GOROKHOV
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.D.
Contact information
Practice address
2012 HAROBI DR, STE B, TUCKER, GA 30084-5161
(404) 477-0400
Mailing address
2012 HAROBI DR, STE B, TUCKER, GA 30084-5161
(404) 477-0400
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
042048
GA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
000786266E
—
GA
Enumeration date
08/25/2006
Last updated
09/27/2013
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