Individual
TIAN MA
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.D.
Contact information
Practice address
450 NORTHSIDE CHEROKEE BLVD, CANTON, GA 30115-8015
(770) 224-1000
(770) 224-2451
Mailing address
201 HOSPITAL RD, CANTON, GA 30114-2408
(770) 720-5100
(404) 851-6325
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
068238
GA
208M00000X
Hospitalist Physician
Primary
068238
GA
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
003127560A
—
GA
Enumeration date
05/08/2009
Last updated
03/07/2018
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