Provider Demographics
NPI:1831179886
Name:FILIATRAULT, ANNETTE D (DPM)
Entity type:Individual
Prefix:
First Name:ANNETTE
Middle Name:D
Last Name:FILIATRAULT
Suffix:
Gender:F
Credentials:DPM
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
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Other - Credentials:
Mailing Address - Street 1:3025 MAPLE DR NE STE 2
Mailing Address - Street 2:
Mailing Address - City:ATLANTA
Mailing Address - State:GA
Mailing Address - Zip Code:30305-2618
Mailing Address - Country:US
Mailing Address - Phone:404-231-1227
Mailing Address - Fax:404-364-0834
Practice Address - Street 1:3025 MAPLE DR NE
Practice Address - Street 2:SUITE 2
Practice Address - City:ATLANTA
Practice Address - State:GA
Practice Address - Zip Code:30305-2618
Practice Address - Country:US
Practice Address - Phone:404-231-1227
Practice Address - Fax:404-364-0834
Is Sole Proprietor?:No
Enumeration Date:2006-01-17
Last Update Date:2025-01-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GAPOD000966213ES0103X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes213ES0103XPodiatric Medicine & Surgery Service ProvidersPodiatristFoot & Ankle Surgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
GA684930021AMedicaid
GA684930021AMedicaid
GA1160300003Medicare NSC
GA48SCCNXMedicare PIN