Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 207V00000X | Obstetrician & Gynecologist | 22614 | SC |
Y | 207VG0400X | Gynecologist | 058445 | GA |
NPI | 1134192529 |
---|---|
Provider Name | Sheri Campbell |
First Address | Carrollton, GA 30117-3857 |
Second Address | Villa Rica, GA 30180-1264 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 08/02/2006 |
Last Update Date | 18/06/2010 |