Healthcare Provider Details

I. General information

NPI: 1598755217
Provider Name (Legal Business Name): PAULA C GREAVES MD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 10/25/2005
Last Update Date: 10/09/2019
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

833 CAMPBELL HILL ST NW SUITE 400
MARIETTA GA
30060-1134
US

IV. Provider business mailing address

833 CAMPBELL HILL ST NW SUITE 400
MARIETTA GA
30060-1134
US

V. Phone/Fax

Practice location:
  • Phone: 770-528-0260
  • Fax: 770-528-0269
Mailing address:
  • Phone: 770-528-0260
  • Fax: 770-528-0269

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207V00000X
TaxonomyObstetrics & Gynecology Physician
License Number043631
License Number StateGA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: