Basic Information
| Provider Information | |||||||||
| NPI: | 1972758506 | ||||||||
| EntityType: | 2 | ||||||||
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| OrganizationName: | EMORY HEALTHCARE WINSHIP CANCER INSTITUTE | ||||||||
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| Mailing Information | |||||||||
| Address1: | 1365C CLIFTON RD NE | ||||||||
| Address2: | SUITE C2056 | ||||||||
| City: | ATLANTA | ||||||||
| State: | GA | ||||||||
| PostalCode: | 303221013 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 4047781900 | ||||||||
| FaxNumber: | 4047785676 | ||||||||
| Practice Location | |||||||||
| Address1: | 1365C CLIFTON RD NE | ||||||||
| Address2: | SUITE C2056 | ||||||||
| City: | ATLANTA | ||||||||
| State: | GA | ||||||||
| PostalCode: | 303221013 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 4047781900 | ||||||||
| FaxNumber: | 4047785676 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 11/24/2008 | ||||||||
| LastUpdateDate: | 11/24/2008 | ||||||||
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| AuthorizedOfficialLastName: | MCDANIEL | ||||||||
| AuthorizedOfficialFirstName: | DONNA | ||||||||
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| AuthorizedOfficialTitleorPosition: | OMCOLOGY NURSE MANAGER WINSHIP | ||||||||
| AuthorizedOfficialTelephone: | 4047783954 | ||||||||
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| IsOrganizationSubpart: | N | ||||||||
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| AuthorizedOfficialNamePrefix: | MS. | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 261QX0200X | RN167522 NP | GA | Y | Ambulatory Health Care Facilities | Clinic/Center | Oncology |
No ID Information.