National Provider Identifier Database

POLARIS MEDICAL GROUP LLC
Specialist

An individual educated and trained in an applied knowledge discipline used in the performance of work at a level requiring knowledge and skills beyond or apart from that provided by a general education or liberal arts degree.


Contact Information

POLARIS MEDICAL GROUP LLC
1136 CLEVELAND AVE
ATLANTA, GA30344
Phone: 404-766-8110
Fax: 404-766-8106
Website:
Specialty Taxonomy Code
* Specialist 174400000X

* Indicates primary specialty

NPI Profile & details for POLARIS MEDICAL GROUP LLC

NPI Number 1366583577
Legal business name
LBN
POLARIS MEDICAL GROUP LLC
Authorized official LISA PERRY-GILKES - (CFO)
Entity Organization
Organization subpart No
Enumeration date 02/09/2007
Last updated 04/03/2009 - About 17 years ago
Sole proprietor1 Not specified
Identifiers
  • GA License #: 052218
  • GA Medicaid: 442333125C

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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