Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207Y00000X | Otolaryngologist (ENT Doctor) | 057267 | GA |
N | 207YP0228X | Pediatric Otolaryngology | 057267 | GA |
NPI | 1174561138 |
---|---|
Provider Name | Dr. Malaika Manju Witter Hewitt |
First Address | Atlanta, GA 30342-1731 |
Second Address | Atlanta, GA 30342-1731 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 03/06/2006 |
Last Update Date | 01/02/2017 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
343624855A | (05) | GA |
343624855B | (05) | GA |
343624855C | (05) | GA |
343624855T | (05) | GA |
343624855U | (05) | GA |
343624855Y | (05) | GA |
52173053 | BCBS OF GEORGIA (01) | GA |
H88562 | (02) | GA |