Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207QA0505X | Family Doctor - Adult Medicine | RN250429 | GA |
NPI | 1306464250 |
---|---|
Provider Name | Leah Reed |
First Address | Cumming, GA 30040 |
Second Address | Cumming, GA 30040 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 08/07/2020 |
Last Update Date | 02/06/2021 |