Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207VX0201X | Gynecologic Oncologist | 86275 | GA |
NPI | 1205155348 |
---|---|
Provider Name | Ms. Kristen D Starbuck |
First Address | Decatur, GA 30033-6147 |
Second Address | Decatur, GA 30033-6147 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 28/05/2010 |
Last Update Date | 02/02/2022 |