Provider Demographics
NPI:1235376658
Name:SEA, TAMIKA LOUISE (MD)
Entity Type:Individual
Prefix:DR
First Name:TAMIKA
Middle Name:LOUISE
Last Name:SEA
Suffix:
Gender:F
Credentials:MD
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Mailing Address - Street 1:290 COUNTRY CLUB DR STE 210
Mailing Address - Street 2:
Mailing Address - City:STOCKBRIDGE
Mailing Address - State:GA
Mailing Address - Zip Code:30281-9022
Mailing Address - Country:US
Mailing Address - Phone:770-538-1723
Mailing Address - Fax:470-202-9820
Practice Address - Street 1:290 COUNTRY CLUB DR STE 210
Practice Address - Street 2:
Practice Address - City:STOCKBRIDGE
Practice Address - State:GA
Practice Address - Zip Code:30281-9022
Practice Address - Country:US
Practice Address - Phone:770-538-1723
Practice Address - Fax:470-202-9820
Is Sole Proprietor?:Yes
Enumeration Date:2009-01-08
Last Update Date:2020-07-03
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Provider Licenses
StateLicense IDTaxonomies
GA67768207V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & Gynecology
Provider Identifiers
StateIdentifier IDID TypeIssuer
GA003154230BMedicaid