Individual
EDUARDO LAMAS BASULTO
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
8225 MALL PKWY, STONECREST, GA 30038-6994
(770) 482-3241
Mailing address
3137 BUFORD HWY NE APT 7, BROOKHAVEN, GA 30329-1756
(786) 274-9963
Taxonomy
Speciality
Code
Description
License number
State
2081P2900X
Pain Medicine (Physical Medicine & Rehabilitation) Physician
Primary
100573
GA
Other
Enumeration date
06/13/2019
Last updated
06/25/2024
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