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General NPI Number Information
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NPI Number | 1659187474
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Entity Type | Individual
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Provider Name | NAYANI TEIXIRA DE OLIVEIRA MACIEL MD
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Gender | Female
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Dates
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Enumeration Date | 12/06/2024
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Last Update Date | 01/22/2025
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Provider Practice Location Address
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Address Line | 777 FRANKLIN GTWY SE
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City | MARIETTA
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State | GA
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Zip | 30067-7803
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Country | US
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Telephone | 770-732-6007
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Fax |
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Provider Business Mailing Address
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Address Line | 5026 RODRICK TRCE
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City | MARIETTA
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State | GA
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Zip | 30066-3227
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Country | US
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Telephone | 404-948-8449
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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 | 208000000X
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Taxonomy Name | Pediatrics Physician
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License Number | 983889
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License Number State | GA
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