Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 2080P0208X | Pediatric Infectious Diseases | 70353 | GA |
N | 2080P0208X | Pediatric Infectious Diseases | MD00040206 | WA |
NPI | 1386727378 |
---|---|
Provider Name | Angela Jp Campbell |
First Address | Atlanta, GA 30329-4018 |
Second Address | Atlanta, GA 30329-4018 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 23/10/2006 |
Last Update Date | 26/09/2013 |