Individual provider · Type 1 NPI

Mauricio Andres Medina Mieles, MD

Student in an Organized Health Care Education/Training Program · Chatsworth, GA

NPI number 1114779113 Active

Practice location

800 Gi Maddox Parkway
Chatsworth, GA 30705

Call (706) 686-8015 Map

Fax (706) 686-8221

Mailing address

1200 Memorial Drive
Dalton, GA 30720

Specialties and licenses

TaxonomyCodeLicense
Student in an Organized Health Care Education/Training Program Primary 390200000X16884 (GA)
Student in an Organized Health Care Education/Training Program 390200000XNone listed

Student in an Organized Health Care Education/Training Program: An individual who is enrolled in an organized health care education/training program leading to a degree, certification, registration, and/or licensure to provide health care.

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About NPI 1114779113

Mauricio Andres Medina Mieles, MD's National Provider Identifier is 1114779113, issued on Apr 3, 2024. The primary taxonomy on file is Student in an Organized Health Care Education/Training Program (390200000X), and the practice location is in Chatsworth, GA. The record was last updated on Sep 27, 2024.