Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 208000000X | Pediatrician | 80729 | GA |
Y | 2080P0207X | Pediatric Hematology-Oncologist | 80729 | GA |
NPI | 1104296177 |
---|---|
Provider Name | Julie Gilbert |
First Address | Atlanta, GA 30342-4723 |
Second Address | Atlanta, GA 30342-4723 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 02/10/2015 |
Last Update Date | 20/05/2021 |