Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 207R00000X | Internist | 036137599 | IL |
N | 111NI0900X | Internist | 036137599 | IL |
N | 207R00000X | Internist | MD-44495 | IA |
N | 111NI0900X | Internist | MD-44495 | IA |
Y | 207RE0101X | Endocrinologist (Diabetes Doctor) | 036137599 | IL |
N | 207RE0101X | Endocrinologist (Diabetes Doctor) | MD-44495 | IA |
NPI | 1013267194 |
---|---|
Provider Name | Dr. Amrutha Mary George |
First Address | Milwaukee, WI 53278-8866 |
Second Address | Rockford, IL 61107-2201 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 14/09/2012 |
Last Update Date | 27/02/2021 |