Teklewold H Lake, PA-C

NPI #1932426210 in Doraville, Georgia

Provider Information

NPI Number: 1932426210
Entity Type: Individual
Name: Teklewold H Lake, PA-C
Gender: Not Specified
Sole Proprietor: No
Primary Specialty: Physician Assistant
Credential: PA-C
Enumeration Date: Apr 27, 2010
Last Updated: Apr 27, 2010

Practice Location

Address: 2830 CLEARVIEW PL
Address 2: SUITE 500
City: Doraville
State: Georgia
ZIP Code: 30340-2134
Phone: (678) 638-0888

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Physician Assistant	363A00000X	Primary

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