Madison Mandula Bazemore, PA
NPI #1306583323 in Gainesville, Georgia
Provider Information
- NPI Number
- 1306583323
- Entity Type
- Individual
- Name
- Madison Mandula Bazemore, PA
- Gender
- Not Specified
- Sole Proprietor
- No
- Primary Specialty
- Physician Assistant
- Credential
- PA
- Enumeration Date
- May 20, 2022
- Last Updated
- Dec 20, 2023
Practice Location
- Address
- 1315 JESSE JEWELL PKWY NE STE 300
- City
- Gainesville
- State
- Georgia
- ZIP Code
- 30501-3875
- Phone
- (770) 848-6190
Specialties & Taxonomy Codes
| Specialty |
|---|
| Student in an Organized Health Care Education/Training Program |
| Physician Assistant |
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