Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207V00000X | Obstetrician & Gynecologist | 044372 | GA |
N | 207VG0400X | Gynecologist | 044372 | GA |
NPI | 1144286865 |
---|---|
Provider Name | Dr. Vonda Roebuck Ware |
First Address | Atlanta, GA 30308-2237 |
Second Address | Atlanta, GA 30308-2237 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 21/04/2006 |
Last Update Date | 20/11/2020 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
1514656 | (05) | TN |
H28419 | (02) | GA |