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General NPI Number Information
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NPI Number | 1154524320
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Entity Type | Individual
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Provider Name | MARY LISA KUHLMAN MD
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Gender | Female
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Dates
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Enumeration Date | 06/06/2007
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Last Update Date | 12/06/2021
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Provider Practice Location Address
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Address Line | 11815 NORTHFALL LN SUITE 1001
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City | ALPHARETTA
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State | GA
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Zip | 30009-7973
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Country | US
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Telephone | 770-663-0026
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Fax | 770-663-1356
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Provider Business Mailing Address
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Address Line | 1761 BROADWAY ST SUITE 100
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City | VALLEJO
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State | CA
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Zip | 94589-2226
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Country | US
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Telephone | 707-645-2700
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Fax | 707-645-2181
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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 | 2084P0800X
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Taxonomy Name | Psychiatry Physician
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License Number | 048258
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License Number State | GA
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