Ampola, Mary
Ampola, Mary is an sole proprietor health care provider with primary practice located at 4523 Wieuca Rd Ne , Atlanta GA 30342-3357. She recently has only one registered license in Allopathic & Osteopathic Physicians / Pediatrics, which is considered as her primary health care specialty. Ampola, Mary can be contacted via phone (404) 250-0666.Contact Information
Primary practice address
4523 Wieuca Rd Ne
Atlanta GA 30342-3357
Phone: (404) 250-0666
Fax:
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Allopathic & Osteopathic Physicians / Pediatrics | 208000000X | 055083 | Georgia |
Profile Details
| NPI number | 1346248309 |
|---|---|
| LBN Legal business name | Ampola, Mary |
| Credentials | Doctor of Medicine (MD) |
| Entity | Individual |
| Sole proprietor 1 | Yes |
| Enumeration date | Jul 13th, 2005 |
| Last updated | Jun 15th, 2024 - about 5 months ago |
1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1346248309 | NPPES |
| Georgia | MEDICAID | 419641674C | |
| Georgia | MEDICAID | 419641674A | |
| Georgia | MEDICAID | 419641674D |
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