Susan D Bulla, MT (ASCP) EMT-I

Primary specialty

Medical TechnologistTaxonomy code 246QM0706X

License

MT (ASCP) 76594

Practice address

86 South Cobb Drive
Mail Zone 0454
Marietta, GA 30066-0454

Phone

(770) 494-4131

Fax

(770) 494-3551

NPI assigned

Jul 9, 2008

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)

Not enrolled

Credentials

Medical Technician

Practice roles

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• Premise Health of Georgia Medical, P.C.

  • Multi-Specialty Clinic/Center
  • Marietta, GA
  • NPI 1013790989
  NPD (past)

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

{
    "created_epoch": "1215561600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1215561600000",
    "number": "1841453701",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "86 SOUTH COBB DRIVE",
            "address_2": "MAIL ZONE 0454",
            "city": "MARIETTA",
            "state": "GA",
            "postal_code": "300660454",
            "telephone_number": "770-494-4131",
            "fax_number": "770-494-3551"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "86 SOUTH COBB DRIVE",
            "address_2": "MAIL ZONE 0454",
            "city": "MARIETTA",
            "state": "GA",
            "postal_code": "300660454",
            "telephone_number": "770-494-4131",
            "fax_number": "770-494-3551"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BULLA",
        "first_name": "SUSAN",
        "middle_name": "D",
        "name_prefix": "Ms.",
        "credential": "MT (ASCP) EMT-I",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2008-07-09",
        "last_updated": "2008-07-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "246QM0706X",
            "taxonomy_group": "",
            "desc": "Specialist/Technologist, Pathology, Medical Technologist",
            "state": null,
            "license": "MT (ASCP) 76594",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Ariella Buglione, BCBA
• Building Blocks Pediatric Therapy
• Building Blocks Pediatrics, LLC
• Built in Health LLC
• Piawoh Ngwe Bujung, MD
• Karen Patricia Bullington, MD
• Vicki Bunke, PH.D.
• Bruce Brooksbank Burdeshaw, RPH
• Brittany Zoe Burdett, CSFA
• Andrea Burgio-Murphy, PHD

• Medical Technologist in Marietta, GA
• Providers in Marietta, GA by specialty
• Medical Technologist in Georgia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 9, 2008; 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.