Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 2080P0208X | Pediatric Infectious Diseases | 061217 | GA |
NPI | 1174735526 |
---|---|
Provider Name | Dr. Andres Felipe Camacho-Gonzalez |
First Address | Atlanta, GA 30324 |
Second Address | Atlanta, GA 30322-1060 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 05/05/2007 |
Last Update Date | 16/07/2008 |