Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207VX0000X | Obstetrician | 078608 | GA |
NPI | 1437340270 |
---|---|
Provider Name | Hector Alejandro Caceres Serrano |
First Address | Carrollton, GA 30117-3857 |
Second Address | Villa Rica, GA 30180-1262 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 07/08/2007 |
Last Update Date | 05/09/2017 |