Madelene Anderson

Individual provider Active NPI Physician Assistant · Cumming, GA

NPI 1265255178 · NPPES record last updated Nov 7, 2024

Key facts

NPI
1265255178
Entity type
Individual (NPI type 1)
Primary specialty
Physician Assistant 363A00000X
Practice address
6115 Autry Mill Rd
Cumming, GA 30028-8522
Phone
(678) 634-3780
NPI assigned
Nov 7, 2024
Sex
Female
Sole proprietor
No

Medicare participation

Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

Medicare enrollment (NPD)
No

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X Yes

Addresses

Primary practice location

6115 Autry Mill Rd
Cumming, GA 30028-8522

Mailing address

6115 Autry Mill Rd
Cumming, GA 30028-8522
Phone (678) 634-3780

Other providers in Cumming, GA

All providers in Cumming, GA · Physician Assistant in Georgia

Sources for this page

Verify at the official NPI Registry.