Provider Demographics
NPI:1649385048
Name:KAMB, MARY LOUISE (MD)
Entity Type:Individual
Prefix:DR
First Name:MARY
Middle Name:LOUISE
Last Name:KAMB
Suffix:
Gender:F
Credentials:MD
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Mailing Address - Street 1:CDC, DSTDP, MS E-02
Mailing Address - Street 2:1600 CLIFTON RD, NE
Mailing Address - City:ATLANTA
Mailing Address - State:GA
Mailing Address - Zip Code:30333
Mailing Address - Country:US
Mailing Address - Phone:404-639-8632
Mailing Address - Fax:404-638-8609
Practice Address - Street 1:ATLANTA VA MEDICAL CENTER
Practice Address - Street 2:1670 CLAIRMONT ROAD
Practice Address - City:DECATUR
Practice Address - State:GA
Practice Address - Zip Code:30333
Practice Address - Country:US
Practice Address - Phone:404-639-8632
Practice Address - Fax:404-638-8609
Is Sole Proprietor?:Yes
Enumeration Date:2006-08-19
Last Update Date:2007-07-08
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
GA033608207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine