Doctor Name: | MS. CARTER MARIE WHATLEY |
NPI Number: | 1033476791 |
Entity Type Code: | Individual (1) |
Gender: | F |
Credentials: | PA-C |
License Number: | 6420 |
Business Practice Address: | 290 Country Club Dr Suite 200 Stockbridge, GA - 302819069 |
Business Phone Number: | 7702285407 |
Business Fax Number: | |
Mailing Address: | 527 Peachtree Hills Cir Ne, ATLANTA |
State: | GA |
Postal Code: | 303054242 |
Phone Number: | 4233602872 |
Fax Number: | |
NPI Enumeration Date: | 04/19/2012 |
NPI Last Update Date: | 04/25/2012 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 363AM0700X |
License Number: | 6420 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | GA |
Taxonomy Type: | Physician Assistants & Advanced Practice Nursing Providers |
Taxonomy Classification: | Physician Assistant |
Taxonomy Specialization: | Medical |
Taxonomy Definition: |