Montana, Suzana Mara

Montana, Suzana Mara is an individual health care provider with primary practice located at 3780 Holcomb Bridge Rd Ste C, Peachtree Corners GA 30092-2701. She recently has only one registered license in Allopathic & Osteopathic Physicians / Pediatrics, which is considered as her primary health care specialty. Montana, Suzana Mara can be contacted via phone (770) 263-9101.

Contact Information

Primary practice address
3780 Holcomb Bridge Rd Ste C Peachtree Corners GA 30092-2701
Phone: (770) 263-9101
Fax: (770) 263-9102
Website:
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Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Pediatrics 208000000X 045097 Georgia

Profile Details

NPI number 1417905878
LBN Legal business name Montana, Suzana Mara
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date May 5th, 2006
Last updated May 5th, 2015 - about 11 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 1417905878 NPPES
Georgia MEDICAID 000773209U

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