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General NPI Number Information
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NPI Number | 1215132725
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Entity Type | Organization
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Legal Business Name | NETPHYSICIAN INC
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Dates
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Enumeration Date | 06/15/2007
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Last Update Date | 08/22/2020
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Provider Practice Location Address
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Address Line | 3039 AMWILER RD SUITE 118
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City | ATLANTA
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State | GA
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Zip | 30360-2824
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Country | US
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Telephone | 770-326-6143
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Fax |
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Provider Business Mailing Address
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Address Line | 5700 LAKE MANOR TRCE
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City | ALPHARETTA
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State | GA
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Zip | 30022-2613
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Country | US
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Telephone | 678-957-0156
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Fax | 678-935-3994
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Authorized Official
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Title or Position | VP OWNER
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Name | SHARON ANN BRUBAKER
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Credential |
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Telephone | 678-957-0156
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207KI0005X
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Taxonomy Name | Clinical & Laboratory Immunology (Allergy & Immunology) Physician
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License Number | GA038561
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License Number State | GA
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