Provider Demographics
NPI:1871531442
Name:WURAPA, ANSON K (MD)
Entity type:Individual
Prefix:
First Name:ANSON
Middle Name:K
Last Name:WURAPA
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
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Mailing Address - Street 1:2665 N DECATUR RD
Mailing Address - Street 2:SUITE 330
Mailing Address - City:DECATUR
Mailing Address - State:GA
Mailing Address - Zip Code:30033-6149
Mailing Address - Country:US
Mailing Address - Phone:404-297-9755
Mailing Address - Fax:404-297-5008
Practice Address - Street 1:2665 N DECATUR RD
Practice Address - Street 2:SUITE 330
Practice Address - City:DECATUR
Practice Address - State:GA
Practice Address - Zip Code:30033-6149
Practice Address - Country:US
Practice Address - Phone:404-297-9755
Practice Address - Fax:404-297-5008
Is Sole Proprietor?:Not Answered
Enumeration Date:2006-06-03
Last Update Date:2007-07-08
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
GA50462207RI0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RI0200XAllopathic & Osteopathic PhysiciansInternal MedicineInfectious Disease
Provider Identifiers
StateIdentifier IDID TypeIssuer
GA00972364AMedicaid
H01843Medicare UPIN
GA44ZCBJMMedicare ID - Type Unspecified