PRO-MED OF ATLANTA, PC; NPI #1730491473

Contact Information

PRO-MED OF ATLANTA, PC

4646 NORTH SHALLOWFORD ROAD
#400
ATLANTA, GA 30338

Phone: 770-676-6000
Fax: 770-392-9805
Website:

	Specialty	Taxonomy Code	Specialty Code	Provider Type
	General Practice	208D00000X	99	Physician/Undefined Physician type[6]

Indicates primary specialty

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

NPI # 1730491473

LBN Legal business name PRO-MED OF ATLANTA, PC

Authorized official SUSAN TANNER - (MEDICAL DOCTOR)

Entity Organization

Organization subpart ¹ No

Enumeration date 07/10/2010

Last updated 07/10/2010 - About 16 years ago

Identifiers

License #

AT2218116

¹ Some organization health care providers are made up of components that furnish different types of health care or have separate physical locations where health care is furnished. These components and physical locations are not themselves legal entities, but are part of the organization health care provider (which is a legal entity). A covered organization provider may decide that its subparts (if it has any) should have their own NPI numbers. If a subpart conducts any HIPAA standard transactions on its own (e.g., separately from its parent), it must obtain its own NPI number.

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PRO-MED OF ATLANTA, PC

Contact Information

Specialty

General Practice

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

Reviews for PRO-MED OF ATLANTA, PC