MEDICARE: DR. MIRIAM PARKER MD

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	207R00000X	Internal Medicine Physician	040511	GA

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1063411924
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. MIRIAM PARKER MD

Provider Business Mailing Address
First Line	:	285 BOULEVARD NE 525
Second Line	:
City	:	ATLANTA
State	:	GA
Zip	:	30312-4211
Country	:	US
Telephone Number	:	404-265-1044
Fax Number	:

Provider Business Practice Location Address
First Line	:	285 BOULEVARD NE
Second Line	:	SUITE 140
City	:	ATLANTA
State	:	GA
Zip	:	30312-4205
Country	:	US
Telephone Number	:	404-265-1044
Fax Number	:	404-265-1047

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	07/21/2005
Last Update Date	:	10/11/2019

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Directions to “ DR. MIRIAM PARKER MD” Practice Location

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