Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 207Q00000X | Family Doctor | GA19515 | GA |
N | 207VG0400X | Gynecologist | GA19515 | GA |
NPI | 1033195557 |
---|---|
Provider Name | David H. Drucker |
First Address | Dalton, GA 30720-2577 |
Second Address | Dalton, GA 30720-2577 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 16/12/2005 |
Last Update Date | 08/07/2007 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
B02937 | (02) | GA |