Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207PP0204X | Pediatric Emergency Physician | 84989 | GA |
NPI | 1174054837 |
---|---|
Provider Name | Brent Michael Troy |
First Address | Atlanta, GA 30322-1060 |
Second Address | Atlanta, GA 30322-1060 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 24/03/2017 |
Last Update Date | 25/06/2021 |