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General NPI Number Information
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NPI Number | 1689674640
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Entity Type | Individual
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Provider Name | MINDY I FINE M.D.
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Gender | Female
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Dates
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Enumeration Date | 07/29/2005
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Last Update Date | 07/08/2007
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Provider Practice Location Address
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Address Line | 1675 CUMBERLAND PKWY SE SUITE 106
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City | SMYRNA
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State | GA
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Zip | 30080-6359
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Country | US
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Telephone | 770-435-7755
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Fax | 770-435-7911
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Provider Business Mailing Address
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Address Line | 1675 CUMBERLAND PKWY SE SUITE 106
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City | SMYRNA
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State | GA
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Zip | 30080-6359
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Country | US
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Telephone | 770-435-7755
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Fax | 770-435-7911
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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 | 207V00000X
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Taxonomy Name | Obstetrics & Gynecology Physician
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License Number | 032382
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License Number State | GA
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