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General NPI Number Information
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NPI Number | 1124178751
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Entity Type | Organization
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Legal Business Name | MARJORIE J. WARREN, MD
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Dates
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Enumeration Date | 01/12/2007
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Last Update Date | 02/25/2009
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Provider Practice Location Address
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Address Line | 155 EAGLES WALK STE F
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City | STOCKBRIDGE
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State | GA
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Zip | 30281-6342
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Country | US
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Telephone | 770-389-8100
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Fax | 770-389-3030
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Provider Business Mailing Address
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Address Line | 2340 PATRICK HENRY PKWY STE 225
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City | MCDONOUGH
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State | GA
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Zip | 30253-4214
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Country | US
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Telephone | 770-389-8100
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Fax | 770-389-3030
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Authorized Official
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Title or Position | PROVIDER
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Name | MARJORIE J WARREN
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Credential | M.D.
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Telephone | 770-389-8100
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 2084P0800X
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Taxonomy Name | Psychiatry Physician
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License Number | 033745
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License Number State | GA
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