Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 207RG0300X | Geriatric Medicine | 059117 | GA |
NPI | 1144382706 |
---|---|
Provider Name | Dr. Nana Abena Arthur |
First Address | Douglasville, GA 30134-2272 |
Second Address | Douglasville, GA 30134 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 13/12/2006 |
Last Update Date | 10/10/2019 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
044538 | PHYSICIAN LICENSE NUMBER (01) | CT |
059117 | PHYSICIAN LICENSE (01) | GA |
BA 9837355 | FEDERAL STATE DEA (01) | GA |