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Contact Information

MARY J NINAN, MD
6300 HOSPITAL PKWY STE 300
JOHNS CREEK, GA30097-1982
 Phone: 770-623-8965
 Fax: 770-623-4018
 Website:
 

Specialty

Taxonomy Code Specialty Code Provider Type

Hematology & Oncology

207RH0003X 11 Physician/Internal Medicine
 

Student in an Organized Health Care Education/Training Program

390200000X
Indicates primary specialty

NPI Profile & details for MARY J NINAN · (Female)

NPI Number 1356533145
Status Active
Credentials MD
Entity Individual
Enumeration date 08/15/2007
Last updated 08/20/2020 - About 6 years ago
Sole proprietor 1 No
Identifiers
  • GA License # 058551
  • TX License # 43128
  • TX License # N7955
  • GA Medicaid 003158193C
  • GA Medicaid 003158193D
  • GA Other G10127A MEDICARE PTAN
Hospital affiliation(s)
  • NORTHSIDE HOSPITAL - (Acute Care)
    1000 JOHNSON FERRY ROAD, NE
    ATLANTA, GA 30342
  • NORTHSIDE HOSPITAL CHEROKEE - (Acute Care)
    201 HOSPITAL ROAD
    CANTON, GA 30114
  • NORTHSIDE HOSPITAL FORSYTH - (Acute Care)
    1200 NORTHSIDE FORSYTH DRIVE
    CUMMING, GA 30041
1 A sole proprietor/sole proprietorship is an individual, and as such, is eligible for a single NPI number. The sole proprietor must apply for the NPI number using his or her own Social Security Number (SSN), not an Employer Identification Number (EIN) even if he/she has an EIN.

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