Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207VG0400X | Gynecologist | 045208 | GA |
NPI | 1184717035 |
---|---|
Provider Name | Dr. Courtney Evans Sinclair |
First Address | Canton, GA 30115 |
Second Address | Canton, GA 30115 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 02/10/2006 |
Last Update Date | 29/08/2007 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
G71136 | (02) |