Individual
SUSAN HARRELL
Active
Sole proprietor
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
1100 LAKE HEARN DR NE, SUITE 100, ATLANTA, GA 30342-1523
(404) 256-3178
(404) 256-3583
Mailing address
1100 LAKE HEARN DR NE, SUITE 100, ATLANTA, GA 30342-1523
(404) 256-3178
(404) 256-3583
Taxonomy
Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
Primary
033100
GA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
257740
BLUE CROSS BLUE SHIELD
—
01
—
40468
GREAT WEST
—
01
—
4289398
AETNA CAPITATED
—
01
—
55091
AETNA
—
01
—
691302
CIGNA HEALTHCARE
—
Enumeration date
04/19/2006
Last updated
07/08/2007
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