Basic Information
| Provider Information | |||||||||
| NPI: | 1356590269 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | VAL | ||||||||
| FirstName: | SYBILE | ||||||||
| MiddleName: | |||||||||
| NamePrefix: | DR. | ||||||||
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| Credential: | M.D. | ||||||||
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| Mailing Information | |||||||||
| Address1: | 33 UPPER RIVERDALE RD SW | ||||||||
| Address2: | STE 112 | ||||||||
| City: | RIVERDALE | ||||||||
| State: | GA | ||||||||
| PostalCode: | 302742626 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 7709963190 | ||||||||
| FaxNumber: | 7709963529 | ||||||||
| Practice Location | |||||||||
| Address1: | 1100 JOHNSON FY RD NE STE 850 | ||||||||
| Address2: | |||||||||
| City: | ATLANTA | ||||||||
| State: | GA | ||||||||
| PostalCode: | 303421733 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 4703816500 | ||||||||
| FaxNumber: | 4703816503 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 09/16/2008 | ||||||||
| LastUpdateDate: | 10/25/2018 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 208200000X | 072839 | GA | Y | Allopathic & Osteopathic Physicians | Plastic Surgery |
No ID Information.