Provider Demographics
NPI:1497723860
Name:BABINO, CLARE MARIE
Entity Type:Individual
Prefix:DR
First Name:CLARE
Middle Name:MARIE
Last Name:BABINO
Suffix:
Gender:F
Credentials:
Other - Prefix:MRS
Other - First Name:CLARE
Other - Middle Name:MARIE
Other - Last Name:NOSEGBE
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:MD
Mailing Address - Street 1:2804 MITCHELL DRIVE
Mailing Address - Street 2:
Mailing Address - City:ATLANTA
Mailing Address - State:GA
Mailing Address - Zip Code:31197
Mailing Address - Country:US
Mailing Address - Phone:404-350-9262
Mailing Address - Fax:
Practice Address - Street 1:1611 SANDS PL SE
Practice Address - Street 2:
Practice Address - City:MARIETTA
Practice Address - State:GA
Practice Address - Zip Code:30067-8785
Practice Address - Country:US
Practice Address - Phone:770-541-2122
Practice Address - Fax:770-541-2229
Is Sole Proprietor?:Yes
Enumeration Date:2006-03-10
Last Update Date:2008-09-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GA031197174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes174400000XOther Service ProvidersSpecialist