Basic Information
| Provider Information | |||||||||
| NPI: | 1720109556 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | HONORE | ||||||||
| FirstName: | MARIN | ||||||||
| MiddleName: | MERCURIUS | ||||||||
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| Credential: | M.D. | ||||||||
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| Mailing Information | |||||||||
| Address1: | 980 JOHNSON FERRY RD | ||||||||
| Address2: | SUITE 720 | ||||||||
| City: | ATLANTA | ||||||||
| State: | GA | ||||||||
| PostalCode: | 303421626 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 4042523898 | ||||||||
| FaxNumber: | 4048430719 | ||||||||
| Practice Location | |||||||||
| Address1: | 980 JOHNSON FERRY RD | ||||||||
| Address2: | SUITE 720 | ||||||||
| City: | ATLANTA | ||||||||
| State: | GA | ||||||||
| PostalCode: | 303421626 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 4042523898 | ||||||||
| FaxNumber: | 4048430719 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 04/02/2007 | ||||||||
| LastUpdateDate: | 04/16/2015 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | Y | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 207V00000X | 062996 | GA | N | Allopathic & Osteopathic Physicians | Obstetrics & Gynecology | 207VF0040X | 062996 | GA | Y | Allopathic & Osteopathic Physicians | Obstetrics & Gynecology | Female Pelvic Medicine and Reconstructive Surgery |
No ID Information.