Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207XP3100X | Pediatric Orthopaedic Surgeon | 64032 | GA |
NPI | 1205983178 |
---|---|
Provider Name | Nicholas Fletcher |
First Address | Atlanta, GA 30329-2309 |
Second Address | Atlanta, GA 30329-2309 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 04/01/2007 |
Last Update Date | 25/06/2021 |