CARDIOLOGY OF SOUTH FORSYTH, P.C.
Osteopathic Medicine at Heathrow Dr, Cumming, GA

License number
Georgia 054290
Category
Osteopathic Medicine
Type
Cardiovascular Disease
Owner
Name: DR. MICHAEL LEE WALLER M.D.
Title: PRESIDENT
Phone: (770) 889-5030
Address
Address
1615 Heathrow Dr, Cumming, GA 30041
National Provider ID: 1083912851
LicenseFiles verified this license of Nov 7, 2017 at the National Plan and Provider Enumeration System.

Organization information

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CARDIOLOGY OF SOUTH FORSYTH, PC

Cumming, GA

Industry:
Medical Doctor's Office
Registration:
Jan 28, 2011
Addresses:
950 Sanders Rd, Cumming, GA 30041 (Physical)
1615 Heathrow Dr, Cumming, GA 30041
State ID:
11007075
Business type:
Domestic Professional Corporation
CFO, Medical Doctor, Owner, Presidents:
Daniela Waller (Secretary), 1615 Heathrow Dr, Cumming, GA 30041 (Physical),Michael Waller (CFO, Medical Doctor, Owner, President), 1615 Heathrow Dr, Cumming, GA 30041 (Physical)

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