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Individual

TARA DAMBACH

Active
Sole proprietor
No

Provider details

NPI number
Gender
F

Contact information

Practice address
625 OLD PEACHTREE RD NW, SUWANEE, GA 30024-2937
(678) 451-8969
Mailing address
6518 SECRET COVE CT, FLOWERY BRANCH, GA 30542-3865

Taxonomy

Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
11235
GA
390200000X
Student in an Organized Health Care Education/Training Program

Other

Enumeration date
03/30/2022
Last updated
11/30/2022
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