Provider Demographics
NPI:1609287291
Name:WALDMAN, MARGOT (DPM)
Entity Type:Individual
Prefix:DR
First Name:MARGOT
Middle Name:
Last Name:WALDMAN
Suffix:
Gender:F
Credentials:DPM
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:102 MARY ALICE PARK RD STE 201
Mailing Address - Street 2:
Mailing Address - City:CUMMING
Mailing Address - State:GA
Mailing Address - Zip Code:30040-2682
Mailing Address - Country:US
Mailing Address - Phone:678-262-4040
Mailing Address - Fax:678-262-4060
Practice Address - Street 1:102 MARY ALICE PARK RD STE 201
Practice Address - Street 2:
Practice Address - City:CUMMING
Practice Address - State:GA
Practice Address - Zip Code:30040-2682
Practice Address - Country:US
Practice Address - Phone:678-262-4040
Practice Address - Fax:678-262-4060
Is Sole Proprietor?:No
Enumeration Date:2014-05-16
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PASC006811213ES0103X
390200000X
GAPOD001481213ES0103X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes213ES0103XPodiatric Medicine & Surgery Service ProvidersPodiatristFoot & Ankle Surgery
No390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program