Provider Demographics
NPI:1346224987
Name:EPPELBAUM, LAWRENCE E (MD)
Entity Type:Individual
Prefix:MR
First Name:LAWRENCE
Middle Name:E
Last Name:EPPELBAUM
Suffix:
Gender:M
Credentials:MD
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Mailing Address - Street 1:2911 PIEDMONT RD N
Mailing Address - Street 2:SUITE E
Mailing Address - City:ATLANTA
Mailing Address - State:GA
Mailing Address - Zip Code:80305
Mailing Address - Country:US
Mailing Address - Phone:404-365-0160
Mailing Address - Fax:404-365-0751
Practice Address - Street 1:2911 PIEDMONT RD NE
Practice Address - Street 2:SUITE E
Practice Address - City:ATLANTA
Practice Address - State:GA
Practice Address - Zip Code:30305-2783
Practice Address - Country:US
Practice Address - Phone:404-365-0160
Practice Address - Fax:404-365-0751
Is Sole Proprietor?:No
Enumeration Date:2005-12-06
Last Update Date:2010-04-20
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
GA38830207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
GRP3459Medicare ID - Type Unspecified
F99281Medicare UPIN