Healthcare Provider Details

I. General information

NPI: 1982834081
Provider Name (Legal Business Name): MARY LYNN EPSTEN CHILLEMI MD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: MARY LYNN EPSTEN MD

II. Dates (important events)

Enumeration Date: 07/23/2009
Last Update Date: 06/22/2026
Certification Date: 06/22/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1229 FRIENDSHIP RD STE 100
BRASELTON GA
30517-5608
US

IV. Provider business mailing address

1240 JESSE JEWELL PKWY SE STE 300
GAINESVILLE GA
30501-3861
US

V. Phone/Fax

Practice location:
  • Phone: 770-532-7202
  • Fax: 770-536-2767
Mailing address:
  • Phone: 770-532-7202
  • Fax: 251-434-3802

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code208000000X
TaxonomyPediatrics Physician
License Number075040
License Number StateGA
# 2
Primary TaxonomyY
Taxonomy Code207X00000X
TaxonomyOrthopaedic Surgery Physician
License Number75040
License Number StateGA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: