Dolores, Effie S

Dolores, Effie S is an sole proprietor health care provider with primary practice located at 4485 Tench Rd Ste 630, Suwanee GA 30024-6740. She recently has only one registered license in Allopathic & Osteopathic Physicians / Pediatrics, which is considered as her primary health care specialty. Dolores, Effie S can be contacted via phone (770) 904-5252.

Contact Information

Primary practice address
4485 Tench Rd Ste 630 Suwanee GA 30024-6740
Phone: (770) 904-5252
Fax:
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Pediatrics 208000000X 043598 Georgia

Profile Details

NPI number 1396736815
LBN Legal business name Dolores, Effie S
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 Yes
Enumeration date Nov 3rd, 2005
Last updated Jan 25th, 2012 - about 14 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 1396736815 NPPES
Georgia MEDICAID 000746281E
Georgia MEDICAID 309852302A

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