Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207RR0500X | Rheumatology | 063972 | GA |
NPI | 1023270576 |
---|---|
Provider Name | Dr. Athanasios Nicholas Tiliakos |
First Address | Atlanta, GA 30303-3049 |
Second Address | Atlanta, GA 30303-3049 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 26/06/2008 |
Last Update Date | 30/06/2010 |