Brooks, Michael Wayne

Brooks, Michael Wayne is an individual health care provider with primary practice located at 868 York Ave Sw , Atlanta GA 30310-2750. He recently has 2 registered licenses in different health care specialties including Allopathic & Osteopathic Physicians / Clinical & Laboratory Immunology, Allopathic & Osteopathic Physicians / Internal Medicine. Allopathic & Osteopathic Physicians / Internal Medicine is his primary health care specialty. Brooks, Michael Wayne can be contacted via phone (404) 752-1400.

Contact Information

Primary practice address
868 York Ave Sw Atlanta GA 30310-2750
Phone: (404) 752-1400
Fax: (404) 758-0740
Website:
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Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Clinical & Laboratory Immunology 207KI0005X 029420 Georgia
Allopathic & Osteopathic Physicians / Internal Medicine 207R00000X 029420 Georgia

Profile Details

NPI number 1174513089
LBN Legal business name Brooks, Michael Wayne
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date Oct 24th, 2005
Last updated Jul 15th, 2013 - about 13 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1174513089 NPPES
Georgia MEDICAID 000352811A

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