Marjorie Anderson, PA
Individual provider Active NPI Physician Assistant · Atlanta, GA
NPI 1649368705 · NPPES record last updated Jul 8, 2007
Key facts
- NPI
- 1649368705
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Physician Assistant 363A00000X
- License
- 634 (GA)
- Practice address
- 1364 Clifton Rd NE
Ste H122
Atlanta, GA 30322-1059 - Phone
- (404) 778-3451
- NPI assigned
- Oct 11, 2006
- 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
- Credentials
- Physician Assistant
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 634 | GA | MD | Physician Assistant |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Physician Assistant | 363A00000X | 634 | GA | Yes |
Addresses
Primary practice location
1364 Clifton Rd NE
Ste H122
Atlanta, GA 30322-1059
Mailing address
1364 Clifton Rd NE
Ste H122
Atlanta, GA 30322-1059
Phone (404) 778-3712
Other providers in Atlanta, GA
- Linda Kline Anderson
- Logan Anderson
- Louis Harrison Anderson Jr.
- Makayla Anderson
- Mariah Danielle Anderson
- Meg Rotenberg Anderson
- Melanie Anderson
- Melissa Hirsu Anderson
- Penelope Alejandra Anderson
- Rosemarie Aneita Anderson
All providers in Atlanta, GA · Physician Assistant in Georgia
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jul 8, 2007. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.