MEDICARE: MR. PATRICK BERNARD PULLIN MD

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	207R00000X	Internal Medicine Physician	049936	GA
2	208M00000X	Hospitalist Physician	49936	GA

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1093704397
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MR. PATRICK BERNARD PULLIN MD

Provider Business Mailing Address
First Line	:	550 PEACHTREE ST NE
Second Line	:
City	:	ATLANTA
State	:	GA
Zip	:	30308-2208
Country	:	US
Telephone Number	:	912-375-4400
Fax Number	:	912-375-4499

Provider Business Practice Location Address
First Line	:	550 PEACHTREE ST NE
Second Line	:
City	:	ATLANTA
State	:	GA
Zip	:	30308-2208
Country	:	US
Telephone Number	:	912-375-4400
Fax Number	:	912-375-4499

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

Provider Enumeration Date	:	10/19/2005
Last Update Date	:	10/08/2015

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