Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207QH0002X | Family Doctor - Hospice and Palliative Medicine | 21252 | GA |
NPI | 1538339726 |
---|---|
Provider Name | Alice Irene Lawver |
First Address | Atlanta, GA 30345 |
Second Address | Decatur, GA 30033 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 04/03/2008 |
Last Update Date | 04/03/2008 |