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Individual

ANTHONY ERVIN

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man

Contact information

Practice address
6251 SMITHPOINT DR. BLDG B, PEACHTREE CORNERS, GA 30093
(404) 832-5030
Mailing address
6251 SMITHPOINT DR. BLDG B, PEACHTREE CORNERS, GA 30093
(404) 832-5030

Taxonomy

Speciality
Code
Description
License number
State
171M00000X
Case Manager/Care Coordinator
Primary
GA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
0000
GA
Enumeration date
11/08/2019
Last updated
11/08/2019
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