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General NPI Number Information
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NPI Number | 1275968158
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Entity Type | Organization
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Legal Business Name | CHICHI BERHANE, MD, L.L.C
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Dates
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Enumeration Date | 09/10/2013
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Last Update Date | 09/10/2013
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Provider Practice Location Address
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Address Line | 3193 HOWELL MILL RD NW SUITE 328
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City | ATLANTA
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State | GA
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Zip | 30327-2119
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Country | US
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Telephone | 404-430-8917
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Fax |
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Provider Business Mailing Address
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Address Line | 2107 MADISON DR
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City | ATLANTA
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State | GA
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Zip | 30346-2437
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Country | US
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Telephone | 404-430-8917
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Fax | 404-350-7381
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Authorized Official
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Title or Position | CEO/COO
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Name | DR. MEDHANIE CHICHI BERHANE
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Credential | MD
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Telephone | 404-430-8917
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 208200000X
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Taxonomy Name | Plastic Surgery Physician
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License Number | 68110
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License Number State | GA
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