Provider Demographics
NPI:1821086802
Name:QUINONES, MICHAEL ANTHONY (MD)
Entity Type:Individual
Prefix:DR
First Name:MICHAEL
Middle Name:ANTHONY
Last Name:QUINONES
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
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Other - Credentials:
Mailing Address - Street 1:5730 GLENRIDGE DR STE 310
Mailing Address - Street 2:
Mailing Address - City:SANDY SPRINGS
Mailing Address - State:GA
Mailing Address - Zip Code:30328-5561
Mailing Address - Country:US
Mailing Address - Phone:404-303-7444
Mailing Address - Fax:404-303-7445
Practice Address - Street 1:5730 GLENRIDGE DR STE 310
Practice Address - Street 2:
Practice Address - City:SANDY SPRINGS
Practice Address - State:GA
Practice Address - Zip Code:30328-5561
Practice Address - Country:US
Practice Address - Phone:404-303-7444
Practice Address - Fax:404-303-7445
Is Sole Proprietor?:Yes
Enumeration Date:2005-10-12
Last Update Date:2021-06-28
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
GA038917208600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208600000XAllopathic & Osteopathic PhysiciansSurgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
GA00626029AMedicaid
GA00626029AMedicaid
GAE36866Medicare UPIN