Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207VX0201X | Gynecologic Oncologist | 87556 | GA |
N | 207VX0201X | Gynecologic Oncologist | OS016977 | PA |
NPI | 1295050706 |
---|---|
Provider Name | Dr. Natalie Shiralia Godbee |
First Address | Newnan, GA 30265-8001 |
Second Address | Newnan, GA 30265-8001 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 29/03/2010 |
Last Update Date | 23/06/2021 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
102923490 | (05) | PA |
87556 | GEORGIA MEDICAL LICENSE (01) | GA |