Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 2080P0205X | Pediatric Endocrinologist | 41932 | GA |
NPI | 1194789982 |
---|---|
Provider Name | Mark Seth Rappaport |
First Address | Atlanta, GA 30342-4755 |
Second Address | Atlanta, GA 30342-4755 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 17/04/2006 |
Last Update Date | 02/07/2021 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
G65529 | (02) | GA |