Provider Demographics
NPI:1407116130
Name:CRUZ, ABIGAIL JOY (MD)
Entity Type:Individual
Prefix:DR
First Name:ABIGAIL
Middle Name:JOY
Last Name:CRUZ
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 1:770 PINE ST STE 520
Mailing Address - Street 2:
Mailing Address - City:MACON
Mailing Address - State:GA
Mailing Address - Zip Code:31201-7567
Mailing Address - Country:US
Mailing Address - Phone:478-633-2694
Mailing Address - Fax:478-633-4146
Practice Address - Street 1:770 PINE ST STE 520
Practice Address - Street 2:
Practice Address - City:MACON
Practice Address - State:GA
Practice Address - Zip Code:31201-7567
Practice Address - Country:US
Practice Address - Phone:478-633-2694
Practice Address - Fax:478-633-4146
Is Sole Proprietor?:No
Enumeration Date:2012-05-29
Last Update Date:2020-09-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GA843282080P0207X
TN564632080P0207X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2080P0207XAllopathic & Osteopathic PhysiciansPediatricsPediatric Hematology-Oncology