MEDICARE: MS. AIMEE MARGARET ABIDE 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
1	363A00000X	Physician Assistant	003434	GA

General Provider Information

NPI Number	:	1902988157
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MS. AIMEE MARGARET ABIDE PA-C

Provider Business Mailing Address
First Line	:	34 JOHNSON FERRY PKWY NE
Second Line	:
City	:	ATLANTA
State	:	GA
Zip	:	30319-4311
Country	:	US
Telephone Number	:	404-851-1323
Fax Number	:

Provider Business Practice Location Address
First Line	:	550 PEACHTREE STREET
Second Line	:	6TH FLOOR MOT
City	:	ATLANTA
State	:	GA
Zip	:	30308-2225
Country	:	US
Telephone Number	:	404-686-2513
Fax Number	:	404-686-4959

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

Provider Enumeration Date	:	10/19/2006
Last Update Date	:	07/08/2007

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