Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 111NN0400X | Neurology | CHIR009534 | GA |
NPI | 1881130078 |
---|---|
Provider Name | Dr. Nicholas Deflumeri |
First Address | Atlanta, GA 30363-1073 |
Second Address | Atlanta, GA 30308-2116 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 11/01/2017 |
Last Update Date | 11/01/2017 |