Healthcare Provider Details
I. General information
NPI: 1922486562
Provider Name (Legal Business Name): NOELLE BRESLIN MD
Entity Type: Individual
Gender: Female
Sole Proprietor: N
II. Dates (important events)
Enumeration Date: 05/15/2015
Last Update Date: 07/08/2026
Certification Date: 07/08/2026
Deactivation Date: 12/28/2015
Reactivation Date: 04/04/2016
III. Provider practice location address
1000 JOHNSON FERRY RD
SANDY SPRINGS GA
30342-1606
US
IV. Provider business mailing address
1000 JOHNSON FERRY RD
SANDY SPRINGS GA
30342-1606
US
V. Phone/Fax
- Phone: 404-851-8988
- Fax:
- Phone: 404-851-8988
- Fax:
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 207VM0101X |
| Taxonomy | Maternal & Fetal Medicine Physician |
| License Number | 102433 |
| License Number State | GA |
| # 2 | |
| Primary Taxonomy | N |
| Taxonomy Code | 207VM0101X |
| Taxonomy | Maternal & Fetal Medicine Physician |
| License Number | 301114 |
| License Number State | NY |
VIII. Authorized Official
Name:
Title or Position:
Credential:
Phone: