Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207VG0400X | Gynecologist | 021025 | GA |
NPI | 1124017116 |
---|---|
Provider Name | Cynthia Ann Mercer |
First Address | Athens, GA 30606-2762 |
Second Address | Athens, GA 30606-2762 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 21/10/2005 |
Last Update Date | 08/07/2007 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
00248806A | (05) | GA |
D40640 | (02) | GA |