Provider Demographics
NPI:1447224324
Name:GARRETT, VERONICA E (MD)
Entity Type:Individual
Prefix:DR
First Name:VERONICA
Middle Name:E
Last Name:GARRETT
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1415 MILSTEAD RD NE
Mailing Address - Street 2:SUITE A
Mailing Address - City:CONYERS
Mailing Address - State:GA
Mailing Address - Zip Code:30012
Mailing Address - Country:US
Mailing Address - Phone:678-413-0858
Mailing Address - Fax:678-413-3340
Practice Address - Street 1:1415 MILSTEAD RD NE
Practice Address - Street 2:SUITE A
Practice Address - City:CONYERS
Practice Address - State:GA
Practice Address - Zip Code:30012
Practice Address - Country:US
Practice Address - Phone:678-413-0858
Practice Address - Fax:678-413-3340
Is Sole Proprietor?:No
Enumeration Date:2006-02-15
Last Update Date:2012-12-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GA039106207V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & Gynecology
Provider Identifiers
StateIdentifier IDID TypeIssuer
GA000633619JMedicaid
GA000633619KMedicaid
F94039Medicare UPIN
GA000633619JMedicaid