Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 2080A0000X | Adolescent Medicine | 072524 | GA |
NPI | 1265759229 |
---|---|
Provider Name | Ms. Anna Chandler Schulenborg |
First Address | Marietta, GA 30062-8620 |
Second Address | Marietta, GA 30062-8620 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 29/04/2010 |
Last Update Date | 26/08/2016 |