Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 207V00000X | Obstetrician & Gynecologist | 062996 | GA |
Y | 207VF0040X | Female Pelvic Medicine and Reconstructive Surgeon | 062996 | GA |
NPI | 1720109556 |
---|---|
Provider Name | Marin Mercurius Honore |
First Address | Atlanta, GA 30342-1626 |
Second Address | Atlanta, GA 30342-1626 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 02/04/2007 |
Last Update Date | 16/04/2015 |