Provider Demographics
NPI:1073327664
Name:CAYEMITTE, MARC ELIE (AGNP-C)
Entity type:Individual
Prefix:
First Name:MARC
Middle Name:ELIE
Last Name:CAYEMITTE
Suffix:
Gender:M
Credentials:AGNP-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:1080 W PEACHTREE ST NW UNIT 708
Mailing Address - Street 2:
Mailing Address - City:ATLANTA
Mailing Address - State:GA
Mailing Address - Zip Code:30309-3830
Mailing Address - Country:US
Mailing Address - Phone:773-895-8542
Mailing Address - Fax:
Practice Address - Street 1:5462 MEMORIAL DR STE 101
Practice Address - Street 2:
Practice Address - City:STONE MOUNTAIN
Practice Address - State:GA
Practice Address - Zip Code:30083-3239
Practice Address - Country:US
Practice Address - Phone:470-544-0854
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-02-04
Last Update Date:2025-02-04
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
GAAG01250064363LG0600X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LG0600XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerGerontology