MEDICARE: POLARIS SPINE & NEUROSURGERY CENTER PC

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	332B00000X	Durable Medical Equipment & Medical Supplies

General Provider Information

NPI Number	:	1528717378
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	POLARIS SPINE & NEUROSURGERY CENTER PC

Provider Business Mailing Address
First Line	:	1150 HAMMOND DR STE 400
Second Line	:
City	:	ATLANTA
State	:	GA
Zip	:	30328-8617
Country	:	US
Telephone Number	:	140-425-6263
Fax Number	:	404-255-6532

Provider Business Practice Location Address
First Line	:	1903 PHOENIX BLVD STE 150
Second Line	:
City	:	COLLEGE PARK
State	:	GA
Zip	:	30349-5700
Country	:	US
Telephone Number	:	404-777-1127
Fax Number	:	404-255-6532

Authorized Official
Title or Position	:	MEDICAL DOCTOR/OWNER
Name	:	DR. MAX STEUER
Credential	:	MD
Telephone Number	:	608-957-3025

Provider Enumeration Date	:	03/21/2022
Last Update Date	:	03/21/2022

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