Provider Demographics
NPI:1528302379
Name:GEORGE, BINUMOL (NP-C)
Entity type:Individual
Prefix:MRS
First Name:BINUMOL
Middle Name:
Last Name:GEORGE
Suffix:
Gender:F
Credentials:NP-C
Other - Prefix:MS
Other - First Name:BINUMOL
Other - Middle Name:
Other - Last Name:MATHEW
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:5154 BOWERS BROOK DR SW
Mailing Address - Street 2:
Mailing Address - City:LILBURN
Mailing Address - State:GA
Mailing Address - Zip Code:30047-5171
Mailing Address - Country:US
Mailing Address - Phone:404-944-7031
Mailing Address - Fax:
Practice Address - Street 1:497 WINN WAY
Practice Address - Street 2:SUITE A-210
Practice Address - City:DECATUR
Practice Address - State:GA
Practice Address - Zip Code:30030-1754
Practice Address - Country:US
Practice Address - Phone:404-294-7033
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2012-11-17
Last Update Date:2012-11-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GARN179444363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily