Provider Demographics
NPI:1528521648
Name:ABBOTT, ASHLEY M (MD)
Entity type:Individual
Prefix:
First Name:ASHLEY
Middle Name:M
Last Name:ABBOTT
Suffix:
Gender:F
Credentials:MD
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Mailing Address - Street 1:900 TOWNE LAKE PKWY
Mailing Address - Street 2:
Mailing Address - City:WOODSTOCK
Mailing Address - State:GA
Mailing Address - Zip Code:30189-1602
Mailing Address - Country:US
Mailing Address - Phone:770-852-7790
Mailing Address - Fax:770-852-7791
Practice Address - Street 1:900 TOWNE LAKE PKWY
Practice Address - Street 2:
Practice Address - City:WOODSTOCK
Practice Address - State:GA
Practice Address - Zip Code:30189-1602
Practice Address - Country:US
Practice Address - Phone:770-852-7790
Practice Address - Fax:770-852-7791
Is Sole Proprietor?:No
Enumeration Date:2019-04-08
Last Update Date:2024-12-04
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Provider Licenses
StateLicense IDTaxonomies
GA101221207RR0500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RR0500XAllopathic & Osteopathic PhysiciansInternal MedicineRheumatology
Provider Identifiers
StateIdentifier IDID TypeIssuer
GA1225050396Medicaid