Healthcare Provider Details

I. General information

NPI: 1881986610
Provider Name (Legal Business Name): INGRID MARIA PINZON QUIROGA M.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/12/2011
Last Update Date: 09/18/2015
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5665 PEACHTREE DUNWOODY RD
ATLANTA GA
30342-1764
US

IV. Provider business mailing address

5665 PEACHTREE DUNWOODY RD
ATLANTA GA
30342-1764
US

V. Phone/Fax

Practice location:
  • Phone: 404-778-6382
  • Fax: 404-778-5495
Mailing address:
  • Phone: 404-778-6382
  • Fax: 404-778-5495

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208M00000X
TaxonomyHospitalist Physician
License Number072081
License Number StateGA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: