Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207RI0200X | Infectious Disease | 78135 | GA |
NPI | 1003108606 |
---|---|
Provider Name | Mary Elizabeth Sexton |
First Address | Decatur, GA 30030-2911 |
Second Address | Atlanta, GA 30322-3725 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 15/05/2011 |
Last Update Date | 13/06/2017 |