National Provider Identifier Database

PRO MED OF ATLANTA PC
General Practice

A physician who specializes in the general practice of diagnosing, treating, and managing patients with a variety of illnesses and conditions.


Contact Information

PRO-MED OF ATLANTA, PC
4646 NORTH SHALLOWFORD ROAD
#400
ATLANTA, GA30338
Phone: 770-676-6000
Fax: 770-392-9805
Website:
Specialty Taxonomy Code
* General Practice 208D00000X

* Indicates primary specialty

NPI Profile & details for PRO-MED OF ATLANTA, PC

NPI Number 1730491473
Legal business name
LBN
PRO-MED OF ATLANTA, PC
Authorized official SUSAN TANNER - (MEDICAL DOCTOR)
Entity Organization
Organization subpart No
Enumeration date 07/10/2010
Last updated 07/10/2010 - About 16 years ago
Sole proprietor1 Not specified
Identifiers
  • GA License #: AT2218116

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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