Provider Demographics
NPI:1326007642
Name:PILZER, EDITH ANN (MD)
Entity Type:Individual
Prefix:
First Name:EDITH
Middle Name:ANN
Last Name:PILZER
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:993-D JOHNSON FERRY ROAD
Mailing Address - Street 2:SUITE 440
Mailing Address - City:ATLANTA
Mailing Address - State:GA
Mailing Address - Zip Code:30342
Mailing Address - Country:US
Mailing Address - Phone:404-257-0799
Mailing Address - Fax:404-503-2280
Practice Address - Street 1:993-D JOHNSON FERRY ROAD
Practice Address - Street 2:SUITE 440
Practice Address - City:ATLANTA
Practice Address - State:GA
Practice Address - Zip Code:30342
Practice Address - Country:US
Practice Address - Phone:404-257-0799
Practice Address - Fax:404-503-2280
Is Sole Proprietor?:No
Enumeration Date:2006-03-23
Last Update Date:2012-02-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GA0250192080P0206X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2080P0206XAllopathic & Osteopathic PhysiciansPediatricsPediatric Gastroenterology
Provider Identifiers
StateIdentifier IDID TypeIssuer
52025935012OtherBLUE CHOICE PROVIDER ID
1904791003OtherCIGNA
916OtherKAISER
GA000301144FMedicaid
1253870OtherUNITED HEALTH CARE
593552OtherBLUE CHOICE FAC INS
2134606OtherAETNA HMO POS
4060592OtherAETNA MC PPO PIN
916OtherKAISER