Healthcare Provider Details

I. General information

NPI: 1932888583
Provider Name (Legal Business Name): JULIANNE ATIENZA MD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/12/2023
Last Update Date: 08/26/2026
Certification Date: 08/26/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1800 10TH AVE
COLUMBUS GA
31901-1529
US

IV. Provider business mailing address

1329 FRONT AVE UNIT 446
COLUMBUS GA
31901-5311
US

V. Phone/Fax

Practice location:
  • Phone: 706-571-1120
  • Fax:
Mailing address:
  • Phone: 347-996-8554
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License Number112981
License Number StateGA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: