MEDICARE: NAOMI K. TEPPER M.D., M.P.H.

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	207V00000X	Obstetrics & Gynecology Physician	0101236360	VA
2	207V00000X	Obstetrics & Gynecology Physician	058610	GA

General Provider Information

NPI Number	:	1083783690
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	NAOMI K. TEPPER M.D., M.P.H.

Provider Business Mailing Address
First Line	:	4770 BUFORD HWY
Second Line	:	MS K-34
City	:	ATLANTA
State	:	GA
Zip	:	30341-3717
Country	:	US
Telephone Number	:	770-488-6506
Fax Number	:

Provider Business Practice Location Address
First Line	:	4770 BUFORD HWY
Second Line	:	MS K-34
City	:	ATLANTA
State	:	GA
Zip	:	30341-3717
Country	:	US
Telephone Number	:	770-488-6506
Fax Number	:

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

Provider Enumeration Date	:	11/07/2006
Last Update Date	:	10/01/2007

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