Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 207V00000X | Obstetrician & Gynecologist | 67423 | GA |
Y | 207VX0201X | Gynecologic Oncologist | 067423 | GA |
NPI | 1184882524 |
---|---|
Provider Name | Michelle A Glasgow |
First Address | Atlanta, GA 30342-4768 |
Second Address | Canton, GA 30115-8023 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 31/05/2008 |
Last Update Date | 07/03/2018 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
003124297E | (05) | GA |
003124297F | (05) | GA |
003124297G | (05) | GA |
003124297H | (05) | GA |