Healthcare Provider Details

I. General information

NPI: 1912467432
Provider Name (Legal Business Name): BIRTHING WAY MIDWIFERY LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 03/21/2019
Last Update Date: 03/21/2019
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3660 CANTON RD STE 240
MARIETTA GA
30066-2660
US

IV. Provider business mailing address

3660 CANTON RD STE 240
MARIETTA GA
30066-2660
US

V. Phone/Fax

Practice location:
  • Phone: 770-877-2560
  • Fax:
Mailing address:
  • Phone: 770-877-2560
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code175M00000X
TaxonomyLay Midwife
License Number
License Number State

VIII. Authorized Official

Name: ELIZABETH MILLER
Title or Position: MIDWIFE
Credential:
Phone: 770-877-2560