Healthcare Provider Details

I. General information

NPI: 1114908936
Provider Name (Legal Business Name): VERLIA GOWER M.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: X

II. Dates (important events)

Enumeration Date: 11/09/2005
Last Update Date: 03/07/2023
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5455 MERIDIAN MARKS RD NE SUITE 130
ATLANTA GA
30342-1654
US

IV. Provider business mailing address

5455 MERIDIAN MARKS RD NE SUITE 130
ATLANTA GA
30342-1654
US

V. Phone/Fax

Practice location:
  • Phone: 404-255-2033
  • Fax: 404-252-1901
Mailing address:
  • Phone: 404-255-2033
  • Fax: 404-252-1901

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207YP0228X
TaxonomyPediatric Otolaryngology Physician
License Number038499
License Number StateGA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: