Individual
WAYNE L AMBROZE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
5445 MERIDIAN MARKS RD, SUITE 180, ATLANTA, GA 30342-4763
(770) 277-4277
(404) 252-5745
Mailing address
5445 MERIDIAN MARKS RD, SUITE 180, ATLANTA, GA 30342-4763
(770) 277-4277
(404) 252-5745
Taxonomy
Speciality
Code
Description
License number
State
208C00000X
Colon & Rectal Surgery Physician
Primary
033019
GA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
00432011B
—
GA
01
—
1129
KAISER
—
01
—
1406030
UNITED HEALTHCAREE
—
01
—
216188012
CIGNA HMO
—
01
—
4120130
AETNA NON HMO
—
01
—
519446
AETNA HMO
—
01
—
52022684
BCBS
—
Enumeration date
05/03/2006
Last updated
10/19/2020
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