MEDICARE: MARC D THAMES 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	207RC0000X	Cardiovascular Disease Physician	77954	GA

General Provider Information

NPI Number	:	1437155074
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MARC D THAMES MD

Provider Business Mailing Address
First Line	:	1956 WESTMINSTER WAY NE
Second Line	:
City	:	ATLANTA
State	:	GA
Zip	:	30307-1137
Country	:	US
Telephone Number	:	602-625-4696
Fax Number	:	404-616-4400

Provider Business Practice Location Address
First Line	:	49 JESSE HILL JR DR SE
Second Line	:
City	:	ATLANTA
State	:	GA
Zip	:	30303-3049
Country	:	US
Telephone Number	:	404-616-0440
Fax Number	:	404-616-4400

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

Provider Enumeration Date	:	06/27/2005
Last Update Date	:	12/17/2018

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