Individual
AMBREEN S ANSARI
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
D.O.
Contact information
Practice address
855 W BROAD ST STE A, ATHENS, GA 30601-2511
(706) 850-6134
Mailing address
1016 E SPRING ST, MONROE, GA 30655-2469
(770) 464-0280
(770) 464-0233
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
86484
GA
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Enumeration date
03/09/2016
Last updated
06/29/2022
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