Healthcare Provider Details

I. General information

NPI: 1194898759
Provider Name (Legal Business Name): ANNA R KUO M.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 11/15/2006
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3193 HOWELL MILL RD NW SUITE 250
ATLANTA GA
30327-2119
US

IV. Provider business mailing address

3193 HOWELL MILL RD NW SUITE 250
ATLANTA GA
30327-2119
US

V. Phone/Fax

Practice location:
  • Phone: 404-351-1131
  • Fax: 404-351-3515
Mailing address:
  • Phone: 404-351-1131
  • Fax: 404-351-3515

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208000000X
TaxonomyPediatrics Physician
License Number037011
License Number StateGA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: