Individual
ELIZABETH MIKRUT
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
902 ATHENS HWY, LOGANVILLE, GA 30052-4904
(770) 554-5533
(770) 554-8129
Mailing address
902 ATHENS HWY, LOGANVILLE, GA 30052-4904
(770) 554-5533
(770) 554-8129
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
29730
GA
Other
Enumeration date
01/08/2007
Last updated
07/08/2007
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