Healthcare Provider Details

I. General information

NPI: 1356543557
Provider Name (Legal Business Name): ANGELINA FOLEY CAIN M.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/01/2007
Last Update Date: 10/26/2021
Certification Date: 10/26/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

711 CANTON RD NE STE 420
MARIETTA GA
30060-8949
US

IV. Provider business mailing address

711 CANTON RD NE STE 420
MARIETTA GA
30060-8949
US

V. Phone/Fax

Practice location:
  • Phone: 678-392-3548
  • Fax: 833-992-2064
Mailing address:
  • Phone: 678-398-7530
  • Fax: 678-402-1483

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207QB0002X
TaxonomyObesity Medicine (Family Medicine) Physician
License Number071103
License Number StateGA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: