Provider Demographics
NPI:1639182132
Name:HUMAN, ANTHONY F (DO)
Entity Type:Individual
Prefix:
First Name:ANTHONY
Middle Name:F
Last Name:HUMAN
Suffix:
Gender:M
Credentials:DO
Other - Prefix:
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Other - Credentials:
Mailing Address - Street 1:1250B AUBURN RD
Mailing Address - Street 2:SUITE 201
Mailing Address - City:DACULA
Mailing Address - State:GA
Mailing Address - Zip Code:30019-5432
Mailing Address - Country:US
Mailing Address - Phone:678-689-6888
Mailing Address - Fax:678-689-6881
Practice Address - Street 1:1250B AUBURN RD
Practice Address - Street 2:SUITE 201
Practice Address - City:DACULA
Practice Address - State:GA
Practice Address - Zip Code:30019-5432
Practice Address - Country:US
Practice Address - Phone:678-689-6888
Practice Address - Fax:678-689-6881
Is Sole Proprietor?:No
Enumeration Date:2006-08-14
Last Update Date:2011-09-21
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
GA056072207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
I40730Medicare UPIN