Provider Demographics
NPI:1275507220
Name:BOAZMAN, VALERIA F (MD)
Entity Type:Individual
Prefix:DR
First Name:VALERIA
Middle Name:F
Last Name:BOAZMAN
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:VALERIA
Other - Middle Name:FULLWOOD
Other - Last Name:SAVAGE
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:PO BOX 742616
Mailing Address - Street 2:
Mailing Address - City:ATLANTA
Mailing Address - State:GA
Mailing Address - Zip Code:30374-2616
Mailing Address - Country:US
Mailing Address - Phone:770-219-8420
Mailing Address - Fax:
Practice Address - Street 1:4445 S LEE ST STE 205
Practice Address - Street 2:
Practice Address - City:BUFORD
Practice Address - State:GA
Practice Address - Zip Code:30518-8807
Practice Address - Country:US
Practice Address - Phone:770-848-7907
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-02-15
Last Update Date:2023-01-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GA052724207V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & Gynecology
Provider Identifiers
StateIdentifier IDID TypeIssuer
GA548300013CMedicaid
GA548300013BMedicaid
GA548300013CMedicaid
GA548300013BMedicaid