Healthcare Provider Details

I. General information

NPI: 1043605348
Provider Name (Legal Business Name): CARIE ANN FOSTER SIRMON MD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: CARIE ANN FOSTER

II. Dates (important events)

Enumeration Date: 04/02/2015
Last Update Date: 01/07/2020
Certification Date: 01/07/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1364 CLIFTON RD NE EMORY UNIVERSITY HOSPITAL
ATLANTA GA
30322-1059
US

IV. Provider business mailing address

423 CLAIREMONT AVE APT 11
DECATUR GA
30030
US

V. Phone/Fax

Practice location:
  • Phone: 410-218-1847
  • Fax:
Mailing address:
  • Phone: 410-218-1847
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code390200000X
TaxonomyStudent in an Organized Health Care Education/Training Program
License Number
License Number StateNULL
# 2
Primary TaxonomyY
Taxonomy Code207L00000X
TaxonomyAnesthesiology Physician
License Number83665
License Number StateGA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: