Organization
FAEBRIS MEDICAL & COMMUNITY EDUCATION
Active
Organization subpart
No
Provider details
NPI number
Authorized official
ZANDRAETTA L TIMS-COOK MD (OWNER)
(770) 905-2347
Entity
Organization
Contact information
Practice address
3939 LAVISTA RD STE E-310, TUCKER, GA 30084-5162
(770) 905-2347
Mailing address
3939 LAVISTA RD STE E-310, TUCKER, GA 30084-5162
(770) 905-2347
Taxonomy
Speciality
Code
Description
License number
State
207RI0200X
Infectious Disease Physician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
15382816338
NPI INDIVIDUAL
—
Enumeration date
09/09/2013
Last updated
09/09/2013
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