=====================================================
General NPI Number Information
=====================================================
NPI Number | 1356543557
-----------------------------------------------------
Entity Type | Individual
-----------------------------------------------------
Provider Name | ANGELINA FOLEY CAIN M.D.
-----------------------------------------------------
Gender | Female
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 06/01/2007
-----------------------------------------------------
Last Update Date | 10/26/2021
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 711 CANTON RD NE STE 420
-----------------------------------------------------
City | MARIETTA
-----------------------------------------------------
State | GA
-----------------------------------------------------
Zip | 30060-8949
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 678-392-3548
-----------------------------------------------------
Fax | 833-992-2064
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 711 CANTON RD NE STE 420
-----------------------------------------------------
City | MARIETTA
-----------------------------------------------------
State | GA
-----------------------------------------------------
Zip | 30060-8949
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 678-398-7530
-----------------------------------------------------
Fax | 678-402-1483
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position |
-----------------------------------------------------
Name |
-----------------------------------------------------
Credential |
-----------------------------------------------------
Telephone |
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 207QB0002X
-----------------------------------------------------
Taxonomy Name | Obesity Medicine (Family Medicine) Physician
-----------------------------------------------------
License Number | 071103
-----------------------------------------------------
License Number State | GA
-----------------------------------------------------