MEDICARE: DR. MARGOT B CSELEY 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	207Q00000X	Family Medicine Physician	020523	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	:	1164411336
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. MARGOT B CSELEY MD

Provider Business Mailing Address
First Line	:	5108 PARKSIDE DR
Second Line	:
City	:	ROSWELL
State	:	GA
Zip	:	30075-7654
Country	:	US
Telephone Number	:	770-395-0426
Fax Number	:	888-980-9760

Provider Business Practice Location Address
First Line	:	268 LAWRENCE ST NE
Second Line	:
City	:	MARIETTA
State	:	GA
Zip	:	30060-1617
Country	:	US
Telephone Number	:	770-421-7738
Fax Number	:	770-421-0394

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

Provider Enumeration Date	:	10/19/2005
Last Update Date	:	09/08/2020

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