Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207QA0505X | Family Doctor - Adult Medicine | 043768 | GA |
NPI | 1043204639 |
---|---|
Provider Name | Dr. Maria A Schiaffino |
First Address | Atlanta, GA 30305 |
Second Address | Kennesaw, GA 30144 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 09/09/2005 |
Last Update Date | 23/07/2009 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
043768 | STATE LICENSE (01) | GA |
BS3779622 | DEA (01) | |
BS3779622 | DEA (01) | GA |
F90488 | (02) | |
F90488 | (02) | GA |