Individual ProviderTian MaHospitalistAllopathic & Osteopathic PhysiciansPractice Address450 Northside Cherokee Blvd, Canton, GA 30115-8015(770) 224-1000(770) 720-5100PECOS EnrollmentBased on the most recent information from CMS, provider Tian Ma is legally eligible to order and refer claims for Part B, HHA, DME and PMD services.Part BMedicare Part BEnrolledHHAHome Health AgencyEnrolledDMEDurable Medical EquipmentEnrolledPMDPower Mobility DeviceEnrolledCMS last updated its PECOS records today at 9:43 AM.Profile DetailsProvider ID1912131616Provider TypeIndividualFull NameMa, TianCredentialM.D.GenderFemaleSole ProprietorNoEnumeration Date5/8/2009Last Updated3/7/2018Contact InformationPractice LocationPractice Address450 Northside Cherokee Blvd, Canton, GA 30115-8015Phone(770) 224-1000Fax(770) 224-2451Mailing LocationMailing Address201 Hospital Rd, Canton, GA 30114-2408Phone(770) 720-5100Fax(404) 851-6325Provider TaxonomiesCodeDescriptionLicenseCode208M00000XPrimaryDescriptionHospitalistAllopathic & Osteopathic PhysiciansLicense068238GeorgiaCode207R00000XDescriptionInternal MedicineAllopathic & Osteopathic PhysiciansLicense068238GeorgiaCode390200000XDescriptionStudent in an Organized Health Care Education/Training ProgramStudent, Health CareLicenseUnlisted IssuerProvider IdentifiersIDDescriptionIssuerID003127560ADescriptionMedicaidIssuerUnlistedGeorgia