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General NPI Number Information
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NPI Number | 1124392717
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Entity Type | Organization
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Legal Business Name | E. MARSTON RASCOE MD PA
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Dates
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Enumeration Date | 02/29/2012
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Last Update Date | 02/29/2012
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Provider Practice Location Address
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Address Line | 2997 PIEDMONT RD NE
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City | ATLANTA
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State | GA
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Zip | 30305-2848
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Country | US
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Telephone | 404-261-3470
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Fax |
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Provider Business Mailing Address
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Address Line | 2997 PIEDMONT RD NE
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City | ATLANTA
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State | GA
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Zip | 30305-2848
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Country | US
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Telephone | 404-261-3470
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | DR. EDWIN MARSTON RASCOE
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Credential | MD PA
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Telephone | 404-261-3470
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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 | 11238
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License Number State | GA
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