Individual
CHRISTOPHER VARDAMAN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
3788 IDLEWILD PL, SUWANEE, GA 30024-4619
(404) 273-5199
Mailing address
3788 IDLEWILD PL, SUWANEE, GA 30024-4619
Taxonomy
Speciality
Code
Description
License number
State
163WR0006X
Registered Nurse First Assistant
Primary
RN173288
GA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
52703540
BCBS ID #
GA
Enumeration date
01/11/2007
Last updated
07/08/2007
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