Individual
LOAN VU
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
D.O.
Contact information
Practice address
3825 MEDICAL PARK DR STE 100, AUSTELL, GA 30106-6831
(470) 267-1760
(470) 986-7002
Mailing address
3825 MEDICAL PARK DR STE 100, AUSTELL, GA 30106-6831
(470) 267-1760
(470) 986-7002
Taxonomy
Speciality
Code
Description
License number
State
207RG0100X
Gastroenterology Physician
Primary
81241
GA
207RG0100X
Gastroenterology Physician
OP60403755
WA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
003163054C
—
GA
05
—
1780909879
—
WA
Enumeration date
03/31/2010
Last updated
11/14/2022
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