MEDICARE: PATRICIA ZARTMAN PAGE MS, CGC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	170300000X	Genetic Counselor (M.S.)

General Provider Information

NPI Number	:	1013906676
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	PATRICIA ZARTMAN PAGE MS, CGC

Provider Business Mailing Address
First Line	:	1573 SCOTT BLVD
Second Line	:
City	:	DECATUR
State	:	GA
Zip	:	30033-6123
Country	:	US
Telephone Number	:	404-636-0665
Fax Number	:	404-778-8564

Provider Business Practice Location Address
First Line	:	2165 N DECATUR RD
Second Line	:
City	:	DECATUR
State	:	GA
Zip	:	30033-5307
Country	:	US
Telephone Number	:	404-778-8513
Fax Number	:	404-778-8564

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	10/17/2005
Last Update Date	:	06/10/2008

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