Ebon Anthony Bourne Md Pa

NPI 1043494479 - Internal Medicine - 207R00000X

NPI Details
NPI 1043494479
Enumeration Date 12/20/2007
Last Updated 03/20/2015
Entity Type Healthcare Provider
Active Over 8 years ago
Authorized Information
Name EBON ANTHONY EBON
Position MD/OWNER
Phone (954) 895-8240
Fax (678) 504-5346
Practice Location
2594 WEDDINGTON RDG NE
MARIETTA GA, 30068-2283, US
Phone (954) 895-8240
Fax (678) 504-5346
Business Location
2595 WEDDINGTON RIDGE
MARIETTA GA, 30068, US
Phone (954) 895-8240
Fax (678) 504-5346
Toxanomy
Taxonomy Code 207R00000X
License State Florida
License Number ME84326
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According to our database, Ebon Anthony Bourne Md Pa NPI is 1043494479, taxonomy code is 207R00000X and license number is ME84326, license state is located at Florida. Ebon Anthony Bourne Md Pa physically located at 2594 Weddington Rdg Ne, Marietta GA, 30068-2283. NPI Number 1033115704 has the healthcare provider type.

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1043494479 NPI number is provided on an as is basis without warranty of any kind. 1043494479 is maintained by the National Plan & Provider Enumeration System. The contents of Ebon Anthony Bourne Md Pa are for informational purposes only.