Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207N00000X | Dermatologist | 41753 | AL |
N | 207N00000X | Dermatologist | MD.205556 | LA |
NPI | 1053601252 |
---|---|
Provider Name | Dr. Amy Theresa Metzger Ananth |
First Address | Atlanta, GA 30374-6984 |
Second Address | Foley, AL 36535-4704 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 10/04/2011 |
Last Update Date | 12/10/2021 |