MEDICARE: ATLANTA HEART GROUP 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	207RC0000X	Cardiovascular Disease Physician	021728	GA

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1760576656
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	ATLANTA HEART GROUP PC

Provider Business Mailing Address
First Line	:	2665 N DECATUR ROAD
Second Line	:	SUITE 260
City	:	DECATUR
State	:	GA
Zip	:	30033-6145
Country	:	US
Telephone Number	:	404-297-9077
Fax Number	:	404-296-1220

Provider Business Practice Location Address
First Line	:	2665 N DECATUR ROAD
Second Line	:	SUITE 260
City	:	DECATUR
State	:	GA
Zip	:	30033-6145
Country	:	US
Telephone Number	:	404-297-9077
Fax Number	:	404-296-1220

Authorized Official
Title or Position	:	PRESIDENT
Name	:	DR. PAUL A KIRSCHBAUM
Credential	:	MD
Telephone Number	:	404-297-9077

Provider Enumeration Date	:	10/03/2006
Last Update Date	:	07/03/2013

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Directions to “ATLANTA HEART GROUP PC ” Practice Location

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