Provider Demographics
NPI:1811183015
Name:MAEGAWA, FELIPE ANTONIO BOFF (MD)
Entity type:Individual
Prefix:
First Name:FELIPE
Middle Name:ANTONIO BOFF
Last Name:MAEGAWA
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
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Other - Credentials:
Mailing Address - Street 1:5673 PEACHTREE DUNWOODY RD STE 680
Mailing Address - Street 2:
Mailing Address - City:ATLANTA
Mailing Address - State:GA
Mailing Address - Zip Code:30342-1804
Mailing Address - Country:US
Mailing Address - Phone:404-778-3712
Mailing Address - Fax:404-778-0820
Practice Address - Street 1:5673 PEACHTREE DUNWOODY RD STE 680
Practice Address - Street 2:
Practice Address - City:ATLANTA
Practice Address - State:GA
Practice Address - Zip Code:30342-1804
Practice Address - Country:US
Practice Address - Phone:404-778-3712
Practice Address - Fax:404-778-0820
Is Sole Proprietor?:No
Enumeration Date:2007-09-20
Last Update Date:2021-08-17
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
AZR71779208600000X
GA89944208600000X
NY59296204F00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208600000XAllopathic & Osteopathic PhysiciansSurgery
No204F00000XAllopathic & Osteopathic PhysiciansTransplant Surgery