Provider Type Icon

ATLANTA COLON AND RECTAL SURGERY PA NPI 1356382865


NPI Information

NPI: 1356382865
Provider Name: ATLANTA COLON AND RECTAL SURGERY, PA
Classification: Colon & Rectal Surgery - 208C00000X
Entity Type: Organization

CLIA Number: 11D1041602

Address:
5667 PEACHTREE DUNWOODY RD NE
SUITE 330
ATLANTA, GA
ZIP 30342
Phone: (404) 252-5669
Get Directions

ATLANTA COLON AND RECTAL SURGERY, PA is a colon rectal surgery in Atlanta, GA. The provider is a colon and rectal surgeon is trained to diagnose and treat various diseases of the intestinal tract, colon, rectum, anal canal and perianal area by medical and surgical means. This specialist also deals with other organs and tissues (such as the liver, urinary and female reproductive system) involved with primary intestinal disease. ATLANTA COLON AND RECTAL SURGERY, PA NPI is 1356382865. The provider is registered as an organization entity type and is a single specialty group.

The provider's business location address is:

5667 PEACHTREE DUNWOODY RD NE
SUITE 330
ATLANTA, GA
ZIP 30342-725
Phone: (404) 252-5669
Fax: (404) 252-9473

The provider's authorized official is Sander Robert Binderow .
The authorized official title is Corporate Secretary and has the following contact phone number (404) 252-5669.

The CLIA number assigned to this NPI record is 11D1041602 - ambulatory surgery center with a certificate type of Certificate of Waiver.

The enumeration date for this NPI number is 6/8/2006 and was last updated on 9/21/2007.


Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.Taxonomy CodeTaxonomy ClasificationTaxonomy SpecializationLicense NumberLicense StatePrimary
1208C00000XColon & Rectal SurgeryYes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No.Other Provider IdentifierOther Provider Identifier TypeOther Provider Identifier StateOther Provider Identifier Issuer
1GRP1704MEDICARE PINGEORGIA

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 4/28/2024

All materials and services on this site are provided on an "as is" and "as available" basis without warranty of any kind. The NPI record is maintained by the National Plan & Provider Enumeration System (NPPES) and anyone may request this information and other NPPES health care provider data from HHS under The Freedom of Information Act (FOIA), Title 5 of the United States Code, section 552. To update the NPI records please contact the NPPES.