Organization Name: | THE BREAST HEALTH CLINIC, PC. |
NPI Number: | 1417079682 |
Entity Type Code: | Organizational (2) |
Authorized Official Name: | STEPHEN PETER AUDA (PRESIDENT) |
Mailing Address: | 325 North Jeff Davis Drive Fayetteville |
State: | GA US |
Postal Code: | 30214 |
Phone Number: | 7704611337 |
Fax Number: | 7704610922 |
NPI Enumeration Date: | 04/06/2007 |
NPI Last Update Date: | 10/25/2011 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 174400000X |
License Number: | |
Healthcare Provider Taxonomy: (Secondary) | N |
State: | |
Taxonomy Type: | Other Service Providers |
Taxonomy Classification: | Specialist |
Taxonomy Specialization: | |
Taxonomy Definition: | An individual educated and trained in an applied knowledge discipline used in the performance of work at a level requiring knowledge and skills beyond or apart from that provided by a general education or liberal arts degree. |