Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207VM0101X | Gynecologist - Maternal & Fetal Medicine | 040974 | GA |
NPI | 1255374625 |
---|---|
Provider Name | Dr. Dexter Page |
First Address | Atlanta, GA 30308 |
Second Address | Atlanta, GA 30308 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 14/06/2006 |
Last Update Date | 30/09/2021 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
000678906 | (05) | GA |
000678906AA | (05) | GA |
000678906C | (05) | GA |
000678906D | (05) | GA |
000678906E | (05) | GA |
000678906G | (05) | GA |
000678906H | (05) | GA |
000678906N | (05) | GA |
000678906P | (05) | GA |
000678906Q | (05) | GA |
000678906T | (05) | GA |