Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207T00000X | Neurosurgeon | R076837 | GA |
NPI | 1003874728 |
---|---|
Provider Name | Carita Lynn Gilreath |
First Address | Atlanta, GA 30342 |
Second Address | Atlanta, GA 30342 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 02/05/2006 |
Last Update Date | 08/07/2007 |