Provider Demographics
NPI:1538397336
Name:HESSE, ELISABETH M (MD)
Entity type:Individual
Prefix:DR
First Name:ELISABETH
Middle Name:M
Last Name:HESSE
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 1:258 LE GRAN BND
Mailing Address - Street 2:
Mailing Address - City:ATLANTA
Mailing Address - State:GA
Mailing Address - Zip Code:30328-6229
Mailing Address - Country:US
Mailing Address - Phone:509-361-3066
Mailing Address - Fax:
Practice Address - Street 1:1825 CENTURY BLVD NE
Practice Address - Street 2:
Practice Address - City:ATLANTA
Practice Address - State:GA
Practice Address - Zip Code:30345-3319
Practice Address - Country:US
Practice Address - Phone:404-498-5084
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2009-06-30
Last Update Date:2018-03-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA01012481182083P0901X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2083P0901XAllopathic & Osteopathic PhysiciansPreventive MedicinePublic Health & General Preventive Medicine