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General NPI Number Information
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NPI Number | 1477892875
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Entity Type | Individual
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Provider Name | ABNNAH BEN NER FORBES PA-C
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Gender | Male
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Dates
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Enumeration Date | 02/05/2013
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Last Update Date | 02/05/2013
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Provider Practice Location Address
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Address Line | 901 RICE ST NW
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City | ATLANTA
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State | GA
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Zip | 30318-4938
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Country | US
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Telephone | 404-613-2097
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Fax |
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Provider Business Mailing Address
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Address Line | 6318 FOGGY OAK DR
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City | FAIRBURN
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State | GA
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Zip | 30213-4675
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Country | US
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Telephone | 404-216-7081
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Fax |
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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 | 363AM0700X
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Taxonomy Name | Medical Physician Assistant
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License Number | 3247
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License Number State | GA
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