Healthcare Provider Details

I. General information

NPI: 1083617401
Provider Name (Legal Business Name): MONICA ELIZABETH PARISE M.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: X

II. Dates (important events)

Enumeration Date: 05/31/2005
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4770 BUFORD HWY
ATLANTA GA
30341-3717
US

IV. Provider business mailing address

2985 LONE STAR TRL
DORAVILLE GA
30340-5021
US

V. Phone/Fax

Practice location:
  • Phone: 770-488-7786
  • Fax: 770-488-4206
Mailing address:
  • Phone: 770-488-7786
  • Fax: 770-488-4206

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207RI0200X
TaxonomyInfectious Disease Physician
License Number042384
License Number StateGA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: