PEACH STATE MEDICAL PRACTICE PC NPI 1891390084

NPI Information

NPI: 1891390084
Provider Name: PEACH STATE MEDICAL PRACTICE, PC
Classification: Obstetrics & Gynecology - 207VE0102X
Entity Type: Organization

Specialization: Reproductive Endocrinology

CLIA Number: 11D2222359

Address:
3005 PEACHTREE RD NE
ATLANTA, GA
ZIP 30305
Phone: (855) 563-2639
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PEACH STATE MEDICAL PRACTICE, PC is a reproductive endocrinology obstetrics gynecology in Atlanta, GA. The provider is an obstetrician/gynecologist who is capable of managing complex problems relating to reproductive endocrinology and infertility. PEACH STATE MEDICAL PRACTICE, PC NPI is 1891390084. The provider is registered as an organization entity type and is a multi-specialty group.

The provider's business location address is:

3005 PEACHTREE RD NE
ATLANTA, GA
ZIP 30305-214
Phone: (855) 563-2639

The provider's authorized official is Fahimeh Sasan .
The authorized official title is Founding Obgyn and has the following contact phone number (855) 563-2639.

The CLIA number assigned to this NPI record is 11D2222359 - physician office with a certificate type of Certificate of Registration.

The enumeration date for this NPI number is 12/3/2020 and was last updated on 12/3/2020.

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	207V00000X	Obstetrics & Gynecology				No
2	207VE0102X	Obstetrics & Gynecology	Reproductive Endocrinology			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

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