Holly Anne Imlach, M.D.

Primary specialty

Gynecology PhysicianTaxonomy code 207VG0400X

License

059243 Issued in GA

Practice address

1380 Milstead Ave NE
Suite E
Conyers, GA 30012-3864

Phone

(678) 609-4913

Fax

(678) 609-4923

NPI assigned

Jan 31, 2007

Last updated

Feb 2, 2011By the provider in NPPES

Sex

Female

Sole proprietor

No

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1170201600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1296604800000",
    "number": "1639216450",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1380 MILSTEAD AVE NE",
            "address_2": "SUITE E",
            "city": "CONYERS",
            "state": "GA",
            "postal_code": "300123864",
            "telephone_number": "678-609-4913",
            "fax_number": "678-609-4923"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1380 MILSTEAD AVE NE",
            "address_2": "SUITE E",
            "city": "CONYERS",
            "state": "GA",
            "postal_code": "300123864",
            "telephone_number": "678-609-4913",
            "fax_number": "678-609-4923"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "IMLACH",
        "first_name": "HOLLY",
        "middle_name": "ANNE",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-01-31",
        "last_updated": "2011-02-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207VG0400X",
            "taxonomy_group": "",
            "desc": "Obstetrics & Gynecology, Gynecology",
            "state": "GA",
            "license": "059243",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Gynecology Physician in Conyers, GA
• Providers in Conyers, GA by specialty
• Gynecology Physician in Georgia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 2, 2011; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.