Provider Demographics
NPI:1104058908
Name:DRUMMOND, MARION L (ST)
Entity type:Individual
Prefix:MS
First Name:MARION
Middle Name:L
Last Name:DRUMMOND
Suffix:
Gender:F
Credentials:ST
Other - Prefix:MS
Other - First Name:MARION
Other - Middle Name:L
Other - Last Name:DRUMMOND
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:ST
Mailing Address - Street 1:750 HAMMOND DR NE
Mailing Address - Street 2:BUILDING 19 STE 300
Mailing Address - City:SANDY SPRINGS
Mailing Address - State:GA
Mailing Address - Zip Code:30328-5532
Mailing Address - Country:US
Mailing Address - Phone:404-257-0363
Mailing Address - Fax:404-257-0338
Practice Address - Street 1:750 HAMMOND DR NE
Practice Address - Street 2:BUILDING 19 STE 300
Practice Address - City:SANDY SPRINGS
Practice Address - State:GA
Practice Address - Zip Code:30328-5532
Practice Address - Country:US
Practice Address - Phone:404-257-0363
Practice Address - Fax:404-257-0338
Is Sole Proprietor?:No
Enumeration Date:2009-08-13
Last Update Date:2009-08-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GA246ZC0007X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes246ZC0007XTechnologists, Technicians & Other Technical Service ProvidersSpecialist/Technologist, OtherSurgical Assistant