Provider Demographics
NPI:1467589879
Name:MCGHEE, THERESA A (PA-C)
Entity Type:Individual
Prefix:MS
First Name:THERESA
Middle Name:A
Last Name:MCGHEE
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Gender:F
Credentials:PA-C
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Mailing Address - Street 1:2140 PEACHTREE RD NW
Mailing Address - Street 2:SUITE 232
Mailing Address - City:ATLANTA
Mailing Address - State:GA
Mailing Address - Zip Code:30309-1314
Mailing Address - Country:US
Mailing Address - Phone:404-231-4431
Mailing Address - Fax:404-231-5677
Practice Address - Street 1:2140 PEACHTREE RD NW
Practice Address - Street 2:SUITE 232
Practice Address - City:ATLANTA
Practice Address - State:GA
Practice Address - Zip Code:30309-1314
Practice Address - Country:US
Practice Address - Phone:404-231-4431
Practice Address - Fax:404-231-5677
Is Sole Proprietor?:No
Enumeration Date:2007-02-27
Last Update Date:2010-11-29
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Provider Licenses
StateLicense IDTaxonomies
GA002545363AM0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363AM0700XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantMedical
Provider Identifiers
StateIdentifier IDID TypeIssuer
GA100001367DMedicaid
P85370Medicare UPIN
GA511I970097Medicare PIN