Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 207RC0000X | Internist - Cardiovascular Disease | 67550 | GA |
Y | 207RC0001X | Clinical Cardiac Electrophysiologist | 67550 | GA |
NPI | 1144407198 |
---|---|
Provider Name | Dr. Cesar Isaac Cruz Aguilar |
First Address | Woodstock, GA 30189-1602 |
Second Address | Woodstock, GA 30189-1602 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 22/01/2008 |
Last Update Date | 28/10/2020 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
003137201D | (05) | GA |
003137201E | (05) | GA |
003148597A | (05) | GA |