Provider Demographics
NPI:1740658384
Name:MCGHEE, TOMIKO GRANADA
Entity type:Individual
Prefix:
First Name:TOMIKO
Middle Name:GRANADA
Last Name:MCGHEE
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3030 WALDROP CIR
Mailing Address - Street 2:
Mailing Address - City:DECATUR
Mailing Address - State:GA
Mailing Address - Zip Code:30034-6797
Mailing Address - Country:US
Mailing Address - Phone:404-493-2632
Mailing Address - Fax:
Practice Address - Street 1:3030 WALDROP CIR
Practice Address - Street 2:
Practice Address - City:DECATUR
Practice Address - State:GA
Practice Address - Zip Code:30034-6797
Practice Address - Country:US
Practice Address - Phone:678-847-1771
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2015-09-14
Last Update Date:2021-07-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171W00000XOther Service ProvidersContractor