Healthcare Provider Details

I. General information

NPI: 1891991154
Provider Name (Legal Business Name): FIONA HAVERS I MD
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 06/25/2007
Last Update Date: 06/01/2026
Certification Date: 06/01/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

80 JESSE HILL JR DR SE
ATLANTA GA
30303-3050
US

IV. Provider business mailing address

407 BRETTON PL
BALTIMORE MD
21218-2507
US

V. Phone/Fax

Practice location:
  • Phone: 404-616-1000
  • Fax:
Mailing address:
  • Phone: 443-416-3195
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207RI0200X
TaxonomyInfectious Disease Physician
License Number67459
License Number StateGA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: