Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 2080P0207X | Pediatric Hematology-Oncologist | 63573 | GA |
NPI | 1083665566 |
---|---|
Provider Name | Carlton Dampier |
First Address | Atlanta, GA 30303-3032 |
Second Address | Atlanta, GA 30303-3032 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 12/05/2006 |
Last Update Date | 25/06/2021 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
E13031 | (02) | PA |