Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 207RI0011X | Interventional Cardiology | 4301079862 | MI |
Y | 207RI0011X | Interventional Cardiology | 87240 | GA |
NPI | 1104807023 |
---|---|
Provider Name | Dr. George S Hanzel |
First Address | Atlanta, GA 30322-1064 |
Second Address | Atlanta, GA 30322-6712 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 08/11/2005 |
Last Update Date | 19/11/2020 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
4624003 | (05) | MI |
H72155 | (02) |