Provider Demographics
NPI:1275704652
Name:CIMMINO, CARA B (MD)
Entity Type:Individual
Prefix:
First Name:CARA
Middle Name:B
Last Name:CIMMINO
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
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Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:1365 CLIFTON RD NE
Mailing Address - Street 2:CLINIC BUILDING B, SUITE B1400
Mailing Address - City:ATLANTA
Mailing Address - State:GA
Mailing Address - Zip Code:30322-1013
Mailing Address - Country:US
Mailing Address - Phone:404-778-4813
Mailing Address - Fax:404-778-4006
Practice Address - Street 1:1365 CLIFTON RD NE
Practice Address - Street 2:CLINIC BUILDING B, SUITE B1400
Practice Address - City:ATLANTA
Practice Address - State:GA
Practice Address - Zip Code:30322-1013
Practice Address - Country:US
Practice Address - Phone:404-778-4813
Practice Address - Fax:404-778-4006
Is Sole Proprietor?:No
Enumeration Date:2008-03-13
Last Update Date:2015-04-08
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
MA229660390200000X
VA0101251383208800000X
GA69387208800000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208800000XAllopathic & Osteopathic PhysiciansUrology
No390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program