MEDICARE: NOVAMED MANAGEMENT SERVICES LLC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	367500000X	Certified Registered Nurse Anesthetist		GA

Medicare Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	CJ6432	OTHER		RR MEDICARE

General Provider Information

NPI Number	:	1457344707
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	NOVAMED MANAGEMENT SERVICES LLC

Provider Business Mailing Address
First Line	:	3200 DOWNWOOD CIR NW
Second Line	:	SUITE 200
City	:	ATLANTA
State	:	GA
Zip	:	30327-1610
Country	:	US
Telephone Number	:	404-355-8721
Fax Number	:	404-355-8797

Provider Business Practice Location Address
First Line	:	3200 DOWNWOOD CIR NW
Second Line	:	SUITE 200
City	:	ATLANTA
State	:	GA
Zip	:	30327-1610
Country	:	US
Telephone Number	:	404-355-8721
Fax Number	:	404-355-8797

Authorized Official
Title or Position	:	OFFICER AND AUTHORIZED OFFICIAL
Name	:	JENNIFER BOYD BALDOCK
Credential	:
Telephone Number	:	615-234-5954

Provider Enumeration Date	:	08/23/2005
Last Update Date	:	03/31/2023

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Directions to “NOVAMED MANAGEMENT SERVICES LLC ” Practice Location

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