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General NPI Number Information
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NPI Number | 1710126362
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Entity Type | Individual
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Provider Name | TARA MARGARELLA D.O.
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Gender | Female
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Dates
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Enumeration Date | 02/05/2009
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Last Update Date | 07/11/2016
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Provider Practice Location Address
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Address Line | 3005 OLD ALABAMA RD SUITE 230
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City | ALPHARETTA
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State | GA
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Zip | 30022-8594
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Country | US
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Telephone | 770-751-9881
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Fax |
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Provider Business Mailing Address
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Address Line | 4260 GLENGARY CT NE
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City | ATLANTA
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State | GA
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Zip | 30342-3520
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Country | US
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Telephone |
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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 | 208600000X
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Taxonomy Name | Surgery Physician
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License Number | 66523
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License Number State | GA
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