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NPI Code Detail

MEDICARE: MRS. DIANNE THORNLEY SHEINTAL PA-C

MEDICARE: MRS. DIANNE THORNLEY SHEINTAL PA-C
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
1363AM0700XMedical Physician Assistant2129GA

General Provider Information

NPI Number : 1710185178
Entity Type Code : Individual
Provider Name (Legal Business Name) : MRS. DIANNE THORNLEY SHEINTAL PA-C
Provider Business Mailing Address
First Line : 4158 SUWANEE TRAIL WAY
Second Line :
City : BUFORD
State : GA
Zip : 30518-8730
Country : US
Telephone Number : 770-932-8411
Fax Number : 770-932-8411
Provider Business Practice Location Address
First Line : 3020 SCENIC HWY S
Second Line :
City : SNELLVILLE
State : GA
Zip : 30039-4614
Country : US
Telephone Number : 770-978-1331
Fax Number : 770-978-8580
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 07/06/2007
Last Update Date : 11/05/2009

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Directions to “ MRS. DIANNE THORNLEY SHEINTAL PA-C” Practice Location

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