Individual provider · Type 1 NPI

Tiago Poleselli Bruniera, PA-C

Surgical Physician Assistant · Athens, GA

NPI number 1164858650 Active

Practice location

1199 Prince Ave Fl 2
Athens, GA 30606

Call (706) 475-1700 Map

Fax (706) 475-1790

Mailing address

2727 Paces Ferry Road SE, Suite 1-1100 (attn: Denise)
Atlanta, GA 30339

Specialties and licenses

TaxonomyCodeLicense
Surgical Physician Assistant Primary 363AS0400X007644 (GA)

Surgical Physician Assistant: Definition to come...

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About NPI 1164858650

Tiago Poleselli Bruniera, PA-C's National Provider Identifier is 1164858650, issued on Sep 17, 2013. The primary taxonomy on file is Surgical Physician Assistant (363AS0400X), and the practice location is in Athens, GA. The record was last updated on Jul 12, 2018.