Mr Wallace Maxwell Green, PAC | |
1275 Highway 54 W, Ste.105, Fayetteville, GA 30214-4549 | |
(770) 719-2965 | |
(770) 719-2963 |
Full Name | Mr Wallace Maxwell Green |
---|---|
Gender | Male |
Speciality | Psychiatry & Neurology - Neurology |
Location | 1275 Highway 54 W, Fayetteville, Georgia |
Accepts Medicare Assignments | Does not participate in Medicare Program. He may not accept medicare assignment. |
Identifier | Type | State | Issuer |
---|---|---|---|
1306979059 | NPI | - | NPPES |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
2084N0400X | Psychiatry & Neurology - Neurology | 001827 (Georgia) | Primary |
Mailing Address | Practice Location Address |
---|---|
Mr Wallace Maxwell Green, PAC 1275 Highway 54 W, Ste.105, Fayetteville, GA 30214-4549 Ph: (770) 719-2965 | Mr Wallace Maxwell Green, PAC 1275 Highway 54 W, Ste.105, Fayetteville, GA 30214-4549 Ph: (770) 719-2965 |
Evan Mccarroll Johnson, MD Psychiatry & Neurology Medicare: Accepting Medicare Assignments Practice Location: 1265 Highway 54 W Ste 500d, Fayetteville, GA 30214 Phone: 770-506-5410 | |
Gary Bruce Lebendiger, MD Psychiatry & Neurology Medicare: Not Enrolled in Medicare Practice Location: 115 Habersham Dr, Fayetteville, GA 30214 Phone: 770-461-9944 Fax: 770-461-9779 | |
Shaw Wendi Fortuchang, M.D. Psychiatry & Neurology Medicare: Not Enrolled in Medicare Practice Location: 110 N Park Dr, Fayetteville, GA 30214 Phone: 770-376-6726 Fax: 770-376-6727 | |
Dr. Olufemi Abiodun Taiwo, M.D Psychiatry & Neurology Medicare: Accepting Medicare Assignments Practice Location: 110 Braxton Ct, Fayetteville, GA 30214 Phone: 678-610-7100 Fax: 678-610-7111 | |
Dr. Ana Maria Cuebas, M.D Psychiatry & Neurology Medicare: Accepting Medicare Assignments Practice Location: 715 Bradley Dr, Fayetteville, GA 30214 Phone: 770-358-5252 | |
Mr. Virendra V Ranadive, MD Psychiatry & Neurology Medicare: Accepting Medicare Assignments Practice Location: 115 Sumner Rd Fl 2, Fayetteville, GA 30214 Phone: 770-716-1562 Fax: 770-716-0145 |