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General NPI Number Information
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NPI Number | 1972764298
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Entity Type | Organization
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Legal Business Name | SUBURBAN HEMATOLOGY ONCOLOGY ASSOCIATES, PC
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Dates
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Enumeration Date | 06/19/2008
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Last Update Date | 06/19/2008
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Provider Practice Location Address
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Address Line | 3855 PLEASANT HILL RD
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City | DULUTH
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State | GA
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Zip | 30096-1407
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Country | US
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Telephone | 770-623-6433
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Fax |
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Provider Business Mailing Address
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Address Line | 3855 PLEASANT HILL RD
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City | DULUTH
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State | GA
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Zip | 30096-1407
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Country | US
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Telephone | 770-623-6433
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Fax |
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Authorized Official
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Title or Position | ADMINISTRATOR
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Name | CANDANCE A HAYES
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Credential |
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Telephone | 678-533-1555
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207RH0003X
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Taxonomy Name | Hematology & Oncology Physician
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License Number |
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License Number State |
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