Provider Demographics
NPI:1760773022
Name:BOZEMAN, ALANA MERYLL (MD)
Entity Type:Individual
Prefix:
First Name:ALANA
Middle Name:MERYLL
Last Name:BOZEMAN
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:ALANA
Other - Middle Name:MERYLL
Other - Last Name:KARP
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MD
Mailing Address - Street 1:595 HURRICANE SHOALS RD NW
Mailing Address - Street 2:SUITE 300
Mailing Address - City:LAWRENCEVILLE
Mailing Address - State:GA
Mailing Address - Zip Code:30046
Mailing Address - Country:US
Mailing Address - Phone:770-995-0823
Mailing Address - Fax:678-252-2249
Practice Address - Street 1:595 HURRICANE SHOALS RD NW
Practice Address - Street 2:SUITE 300
Practice Address - City:LAWRENCEVILLE
Practice Address - State:GA
Practice Address - Zip Code:30046
Practice Address - Country:US
Practice Address - Phone:770-995-0823
Practice Address - Fax:678-252-2249
Is Sole Proprietor?:No
Enumeration Date:2011-04-21
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GA716842080P0210X, 208000000X
390200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208000000XAllopathic & Osteopathic PhysiciansPediatrics
No2080P0210XAllopathic & Osteopathic PhysiciansPediatricsPediatric Nephrology
No390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program