Individual
CAROLYN F BANNISTER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
MD
Contact information
Practice address
2540 WINDY HILL RD SE, MARIETTA, GA 30067-8605
(470) 644-1274
(470) 644-1119
Mailing address
2540 WINDY HILL RD SE, MARIETTA, GA 30067-8605
(470) 644-1274
(470) 644-1119
Taxonomy
Speciality
Code
Description
License number
State
207L00000X
Anesthesiology Physician
Primary
029840
GA
207LP3000X
Pediatric Anesthesiology Physician
ME121972
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
000463119N
—
GA
05
—
013892600
—
FL
Enumeration date
05/12/2006
Last updated
11/14/2022
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