Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 1223S0112X | Oral and Maxillofacial Surgeon | DN013687 | GA |
Y | 204E00000X | Oral & Maxillofacial Surgeon | DN013687 | GA |
NPI | 1083889661 |
---|---|
Provider Name | Dr. Amy Diane Kuhmichel |
First Address | Atlanta, GA 30342-1705 |
Second Address | Atlanta, GA 30327-4100 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 24/04/2008 |
Last Update Date | 18/07/2019 |