Provider Demographics
NPI:1093442295
Name:KING, ANDREW PHILIP (CGC)
Entity type:Individual
Prefix:
First Name:ANDREW
Middle Name:PHILIP
Last Name:KING
Suffix:
Gender:M
Credentials:CGC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4553 WINTERS CHAPEL RD
Mailing Address - Street 2:
Mailing Address - City:ATLANTA
Mailing Address - State:GA
Mailing Address - Zip Code:30360-2707
Mailing Address - Country:US
Mailing Address - Phone:470-596-1313
Mailing Address - Fax:
Practice Address - Street 1:4553 WINTERS CHAPEL RD
Practice Address - Street 2:
Practice Address - City:ATLANTA
Practice Address - State:GA
Practice Address - Zip Code:30360-2707
Practice Address - Country:US
Practice Address - Phone:470-596-1313
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-08-07
Last Update Date:2025-08-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GA718170300000X
170300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes170300000XOther Service ProvidersGenetic Counselor, MS