A Matthew Brunner PA-C

NPI 1811993223 - Physician Assistant - 363A00000X

NPI Details
NPI 1811993223
Gender Male
Enumeration Date 06/22/2005
Last Updated 04/17/2008
Entity Type Individual
Active Over 11 years ago
Practice Location
210 VILLAGE CENTER PKWY
STOCKBRIDGE GA, 30281-9044, US
Phone (770) 474-5952
Fax (770) 474-1300
Business Location
210 VILLAGE CENTER PKWY
STOCKBRIDGE GA, 30281-9044, US
Phone (770) 474-5952
Fax (770) 474-1300
Toxanomy
Taxonomy Code 363A00000X
License State Georgia
License Number 003575
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According to our database, A Matthew Brunner PA-C NPI is 1811993223, taxonomy code is 363A00000X and license number is 003575, license state is located at Georgia. A Matthew Brunner PA-C physically located at 210 Village Center Pkwy, Stockbridge GA, 30281-9044. NPI Number A Matthew Brunner PA-C has the Individual type.

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1811993223 NPI number is provided on an as is basis without warranty of any kind. 1811993223 is maintained by the National Plan & Provider Enumeration System. The contents of A Matthew Brunner PA-C are for informational purposes only.