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Individual

MATT MCMICHAEL

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
CSFA

Contact information

Practice address
5445 MERIDIAN MARK RD STE 100, ATLANTA, GA 30342-4755
(404) 459-1875
Mailing address
1182 OLD PENDERGRASS RD, JEFFERSON, GA 30549-2763
(541) 525-2829

Taxonomy

Speciality
Code
Description
License number
State
246ZC0007X
Surgical Assistant
Primary
167967
GA

Other

Enumeration date
04/19/2023
Last updated
04/19/2023
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