Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207RN0300X | Nephrologist | 021512 | GA |
NPI | 1063444883 |
---|---|
Provider Name | Dr. Stuart Handelsman |
First Address | Atlanta, GA 30342 |
Second Address | Atlanta, GA 30342 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 06/07/2006 |
Last Update Date | 08/07/2007 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
146791 | BCBS GEORGIA (01) | GA |
D29678 | (02) | GA |