Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207VX0201X | Gynecologic Oncologist | 073310 | GA |
N | 207VX0201X | Gynecologic Oncologist | 41332 | MA |
NPI | 1104892157 |
---|---|
Provider Name | Dr. Julia T. Donovan |
First Address | Augusta, GA 30901-2602 |
Second Address | Augusta, GA 30912-0004 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 28/02/2006 |
Last Update Date | 12/02/2016 |