Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 208000000X | Pediatrician | 069686 | GA |
Y | 2080P0208X | Pediatric Infectious Diseases | 069686 | GA |
NPI | 1528247525 |
---|---|
Provider Name | Dr. Julie Seale Martin |
First Address | Atlanta, GA 30321-1435 |
Second Address | Athens, GA 30606-2179 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 26/10/2007 |
Last Update Date | 26/10/2015 |