Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207RI0200X | Infectious Disease | 058863 | GA |
NPI | 1073718516 |
---|---|
Provider Name | Dr. Andrew Dold |
First Address | Tucker, GA 30084-8128 |
Second Address | Gainesville, GA 30501-3806 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 15/06/2007 |
Last Update Date | 24/11/2014 |