Provider Demographics
NPI:1528350220
Name:QUILTER, LAURA ANN SIDELI (MD)
Entity type:Individual
Prefix:
First Name:LAURA
Middle Name:ANN SIDELI
Last Name:QUILTER
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 1:1244 WYLIE ST SE
Mailing Address - Street 2:
Mailing Address - City:ATLANTA
Mailing Address - State:GA
Mailing Address - Zip Code:30317-1634
Mailing Address - Country:US
Mailing Address - Phone:812-369-7772
Mailing Address - Fax:
Practice Address - Street 1:10 PARK PLACE SOUTH SE
Practice Address - Street 2:
Practice Address - City:ATLANTA
Practice Address - State:GA
Practice Address - Zip Code:30303-2913
Practice Address - Country:US
Practice Address - Phone:770-520-7500
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2011-05-12
Last Update Date:2024-07-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GA79753207RI0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RI0200XAllopathic & Osteopathic PhysiciansInternal MedicineInfectious Disease