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Organization

WARLITO G ROLLOLAZO

Active
Other names
Center for General Medicine
Organization subpart
No

Provider details

NPI number
Authorized official
WARLITO G ROLLOLAZO MD (OWNER)
(770) 456-9993
Entity
Organization

Contact information

Practice address
809 W BANKHEAD HWY, SUITE D, VILLA RICA, GA 30180-1520
(770) 456-9993
(770) 456-9949
Mailing address
809 W BANKHEAD HWY, SUITE D, VILLA RICA, GA 30180-1520
(770) 456-9993
(770) 456-9949

Taxonomy

Speciality
Code
Description
License number
State
208D00000X
General Practice Physician
Primary
17551
GA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
000114133G
GA
05
143087983A
GA
Enumeration date
03/26/2007
Last updated
06/13/2008
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