Provider Demographics
NPI:1952596157
Name:SEGARRA-BRECHTEL, ANA R (MD)
Entity type:Individual
Prefix:
First Name:ANA
Middle Name:R
Last Name:SEGARRA-BRECHTEL
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1325 SATELLITE BLVD NW
Mailing Address - Street 2:
Mailing Address - City:SUWANEE
Mailing Address - State:GA
Mailing Address - Zip Code:30024-4651
Mailing Address - Country:US
Mailing Address - Phone:678-263-3080
Mailing Address - Fax:678-496-9863
Practice Address - Street 1:1325 SATELLITE BLVD NW
Practice Address - Street 2:
Practice Address - City:SUWANEE
Practice Address - State:GA
Practice Address - Zip Code:30024-4651
Practice Address - Country:US
Practice Address - Phone:678-263-3080
Practice Address - Fax:678-496-9863
Is Sole Proprietor?:No
Enumeration Date:2007-09-11
Last Update Date:2021-07-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GA0603252084P0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084P0800XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPsychiatry
Provider Identifiers
StateIdentifier IDID TypeIssuer
GA511I260131OtherMEDICARE PROVIDER NUMBER
GAHOSP61131Medicare UPIN