PRO-MED OF ATLANTA PC NPI 1730491473

NPI Information

NPI: 1730491473
Provider Name: PRO-MED OF ATLANTA, PC
Classification: General Practice - 208D00000X
Entity Type: Organization
Address:
4646 NORTH SHALLOWFORD ROAD
#400
ATLANTA, GA
ZIP 30338
Phone: (770) 676-6000
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PRO-MED OF ATLANTA, PC is a general practice in Atlanta, GA. PRO-MED OF ATLANTA, PC NPI is 1730491473. The provider is registered as an organization entity type and is a multi-specialty group.

The provider's business location address is:

4646 NORTH SHALLOWFORD ROAD
#400
ATLANTA, GA
ZIP 30338
Phone: (770) 676-6000
Fax: (770) 392-9805

The provider's authorized official is Susan Tanner .
The authorized official title is Medical Doctor and has the following contact phone number (770) 676-6000.

The enumeration date for this NPI number is 7/10/2010 and was last updated on 7/10/2010.

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 Code	Taxonomy Clasification	Taxonomy Specialization	License Number	License State	Primary
1	208D00000X	General Practice				No
2	208D00000X	General Practice		AT2218116	GEORGIA	Yes

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: 11/14/2023

NPI Synchronization or Removal

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