Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 208100000X | Physical Medicine & Rehabilitation Doctor | 080266 | GA |
NPI | 1033525878 |
---|---|
Provider Name | Ugo Bitussi |
First Address | Dallas, TX 75390-9055 |
Second Address | Duluth, GA 30096-3223 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 01/07/2014 |
Last Update Date | 22/11/2021 |