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NORTHEAST ATLANTA EAR NOSE & THROAT PC NPI 1194836254


NPI Information

NPI: 1194836254
Provider Name: NORTHEAST ATLANTA EAR NOSE & THROAT, PC
Classification: Otolaryngology - 207Y00000X
Entity Type: Organization

CLIA Number: 11D2082535

Address:
3915 JOHNS CREEK COURT
SUITE 100
SUWANEE, GA
ZIP 30024
Phone: (770) 237-3000
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NORTHEAST ATLANTA EAR NOSE & THROAT, PC is an otolaryngology in Suwanee, GA. The provider is an otolaryngologist-head and neck surgeon provides comprehensive medical and surgical care for patients with diseases and disorders that affect the ears, nose, throat, the respiratory and upper alimentary systems and related structures of the head and neck. An otolaryngologist diagnoses and provides medical and/or surgical therapy or prevention of diseases, allergies, neoplasms, deformities, disorders and/or injuries of the ears, nose, sinuses, throat, respiratory and upper alimentary systems, face, jaws and the other head and neck systems. Head and neck oncology, facial plastic and reconstructive surgery and the treatment of disorders of hearing and voice are fundamental areas of expertise. NORTHEAST ATLANTA EAR NOSE & THROAT, PC NPI is 1194836254. The provider is registered as an organization entity type and is a multi-specialty group.

The provider's business location address is:

3915 JOHNS CREEK COURT
SUITE 100
SUWANEE, GA
ZIP 30024
Phone: (770) 237-3000
Fax: (678) 992-2536

The provider's authorized official is Nina Fischbach .
The authorized official title is Ceo and has the following contact phone number (770) 939-9614.

The CLIA number assigned to this NPI record is 11D2082535 - physician office with a certificate type of Certificate of Waiver.

The enumeration date for this NPI number is 8/31/2006 and was last updated on 4/26/2022.


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
1174400000XSpecialistNo
2207Y00000XOtolaryngologyYes

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
1055001197AMEDICAIDGEORGIA

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.