Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 204F00000X | Transplant Surgeon | 011505 | GA |
NPI | 1104969377 |
---|---|
Provider Name | Dr. John Whelchel |
First Address | Atlanta, GA 30368-2321 |
Second Address | Atlanta, GA 30309-1281 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 15/02/2007 |
Last Update Date | 08/07/2007 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
D31324 | (02) | GA |