Individual
DR. PHILLIP HIROTO NAKANO
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
3096 PEACHTREE INDUSTRIAL BLVD, DULUTH, GA 30097-7918
(770) 495-1477
(770) 495-1488
Mailing address
3096 PEACHTREE INDUSTRIAL BLVD, DULUTH, GA 30097-7918
(770) 495-1477
(770) 495-1488
Taxonomy
Speciality
Code
Description
License number
State
208200000X
Plastic Surgery Physician
Primary
024310
GA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
00486351A
—
GA
01
—
52026987
BCBS
GA
01
—
686583
FIRST HEALTH
GA
Enumeration date
09/25/2006
Last updated
07/08/2007
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