Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 204F00000X | Transplant Surgeon | 59296 | NY |
Y | 208200000X | Surgeon | 89944 | GA |
Y | 208600000X | Surgeon | 89944 | GA |
N | 208200000X | Surgeon | R71779 | AZ |
N | 208600000X | Surgeon | R71779 | AZ |
NPI | 1811183015 |
---|---|
Provider Name | Felipe Antonio Boff Maegawa |
First Address | Atlanta, GA 30342-1804 |
Second Address | Atlanta, GA 30342-1804 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 20/09/2007 |
Last Update Date | 17/08/2021 |