Organization
MAK ANESTHESIA EWSC LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
PAMELA A WEIGANDT MD (PRESIDENT)
(770) 702-1806
Entity
Organization
Contact information
Practice address
2041 MESA VALLEY WAY, STE 125, AUSTELL, GA 30106-6828
(678) 309-8100
Mailing address
1635 OLD 41 HIGHWAY NW, SUITE 112-328, KENNESAW, GA 30152
(770) 702-1806
(770) 693-0810
Taxonomy
Speciality
Code
Description
License number
State
207L00000X
Anesthesiology Physician
Primary
—
—
Other
Enumeration date
01/13/2012
Last updated
11/01/2016
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