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NPI Code Detail

MEDICARE: MRS. NHU V BERTOLLI PA-C

MEDICARE:  MRS. NHU V BERTOLLI  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
1363A00000XPhysician Assistant066419GA

General Provider Information

NPI Number : 1851634794
Entity Type Code : Individual
Provider Name (Legal Business Name) : MRS. NHU V BERTOLLI PA-C
Provider Business Mailing Address
First Line : 3390 PEACHTREE RD NE
Second Line : SUITE 1500
City : ATLANTA
State : GA
Zip : 30326-1157
Country : US
Telephone Number : 404-920-4950
Fax Number : 404-920-4959
Provider Business Practice Location Address
First Line : 3390 PEACHTREE RD NE
Second Line : SUITE 1500
City : ATLANTA
State : GA
Zip : 30326-1157
Country : US
Telephone Number : 404-920-4950
Fax Number : 404-920-4959
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 03/28/2013
Last Update Date : 05/11/2015

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Directions to “ MRS. NHU V BERTOLLI PA-C” Practice Location

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