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Contact Information

POLARIS MEDICAL GROUP LLC
1136 CLEVELAND AVE
ATLANTA, GA30344
 Phone: 404-766-8110
 Fax: 404-766-8106
 Website:
 

Specialty

Taxonomy Code Specialty Code Provider Type

Specialist

174400000X
Indicates primary specialty

NPI Profile & details for POLARIS MEDICAL GROUP LLC · (Female)

NPI Number 1366583577
Status Active
Credentials
Entity Individual
Enumeration date 02/09/2007
Last updated 04/03/2009 - About 17 years ago
Sole proprietor 1 Not specified
Identifiers
  • GA License # 052218
  • GA Medicaid 442333125C
Hospital affiliation(s) Not Available
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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