MEDICARE: MONICA B UMPIERREZ M.D.

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	2085R0202X	Diagnostic Radiology Physician	036663	GA

General Provider Information

NPI Number	:	1730167925
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MONICA B UMPIERREZ M.D.

Provider Business Mailing Address
First Line	:	1100 JOHNSON FERRY RD NE
Second Line	:	STE 245
City	:	ATLANTA
State	:	GA
Zip	:	30342-1709
Country	:	US
Telephone Number	:	404-250-6797
Fax Number	:	404-256-3271

Provider Business Practice Location Address
First Line	:	5665 PEACHTREE DUNWOODY RD NE
Second Line	:
City	:	ATLANTA
State	:	GA
Zip	:	30342-1764
Country	:	US
Telephone Number	:	404-257-2450
Fax Number	:	404-256-3271

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

Provider Enumeration Date	:	01/06/2006
Last Update Date	:	07/08/2007

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