Provider Demographics
NPI:1255328720
Name:ABRUZESE, CAROLINE M (MD)
Entity Type:Individual
Prefix:
First Name:CAROLINE
Middle Name:M
Last Name:ABRUZESE
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:800 MOUNT VERNON HWY NE
Mailing Address - Street 2:SUITE 160
Mailing Address - City:SANDY SPRINGS
Mailing Address - State:GA
Mailing Address - Zip Code:30328-4295
Mailing Address - Country:US
Mailing Address - Phone:404-303-8889
Mailing Address - Fax:404-303-8887
Practice Address - Street 1:800 MOUNT VERNON HWY NE
Practice Address - Street 2:SUITE 160
Practice Address - City:SANDY SPRINGS
Practice Address - State:GA
Practice Address - Zip Code:30328-4295
Practice Address - Country:US
Practice Address - Phone:404-303-8889
Practice Address - Fax:404-303-8887
Is Sole Proprietor?:Yes
Enumeration Date:2005-09-30
Last Update Date:2010-12-30
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
GA043518207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
GA11BDVBWMedicare ID - Type Unspecified
GAG54780Medicare UPIN