PREMIER CARDIOTHORACIC SURGERY LLC NPI 1902337637

NPI Information

  • NPI: 1902337637
  • Provider Name: PREMIER CARDIOTHORACIC SURGERY, LLC
  • Classification: Thoracic Surgery (Cardiothoracic Vascular Surgery) - 208G00000X
  • Entity Type: Organization
  • Address: 688 WALNUT ST
    SUITE 102
    MACON, GA
    ZIP 31201
  • Phone: (478) 955-1804

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NPI Details

PREMIER CARDIOTHORACIC SURGERY, LLC is a thoracic surgery cardiothoracic vascular surgery in Macon, GA. The provider is a thoracic surgeon provides the operative, perioperative and critical care of patients with pathologic conditions within the chest. Included is the surgical care of coronary artery disease, cancers of the lung, esophagus and chest wall, abnormalities of the trachea, abnormalities of the great vessels and heart valves, congenital anomalies, tumors of the mediastinum and diseases of the diaphragm. The management of the airway and injuries of the chest is within the scope of the specialty. PREMIER CARDIOTHORACIC SURGERY, LLC NPI is 1902337637. The provider is registered as an organization entity type and is a multi-specialty group.

The provider's business location address is:

688 WALNUT ST
SUITE 102
MACON, GA
ZIP 31201-677
Phone: (478) 955-1804

The provider's authorized official is Fady Wanna .
The authorized official title is M.d. and has the following contact phone number (478) 955-1804.

The enumeration date for this NPI number is 3/24/2017 and was last updated on 3/24/2017.

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
1208G00000XThoracic Surgery (Cardiothoracic Vascular Surgery)043813GEORGIAYes

What is NPI?

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This page was last updated on: 11/21/2025

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