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General NPI Number Information
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NPI Number | 1073574307
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Entity Type | Individual
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Provider Name | HONG LI M.D.
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Gender | Female
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Dates
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Enumeration Date | 03/28/2006
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Last Update Date | 05/17/2010
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Provider Practice Location Address
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Address Line | 3576 SHALLOWFORD RD NE SUITE A
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City | CHAMBLEE
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State | GA
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Zip | 30341-2998
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Country | US
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Telephone | 770-451-9940
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Fax | 770-451-6996
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Provider Business Mailing Address
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Address Line | 217 SOUTHERN HILL DR
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City | DULUTH
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State | GA
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Zip | 30097-2062
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Country | US
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Telephone | 770-495-7071
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207Q00000X
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Taxonomy Name | Family Medicine Physician
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License Number | 045086
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License Number State | GA
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