MEDICARE: DR. JAMES ALEXANDER DOLAK M.D., PH.D.

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	207L00000X	Anesthesiology Physician	036072	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
2	036072	OTHER	GA	MEDICAL LICENSE

General Provider Information

NPI Number	:	1811965445
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. JAMES ALEXANDER DOLAK M.D., PH.D.

Provider Business Mailing Address
First Line	:	550 PEACHTREE ST NE
Second Line	:	DEPT. OF ANESTHESIOLOGY, EMORY CRAWFORD LONG HOSP
City	:	ATLANTA
State	:	GA
Zip	:	30308-2247
Country	:	US
Telephone Number	:	404-686-2316
Fax Number	:	404-686-4949

Provider Business Practice Location Address
First Line	:	550 PEACHTREE ST NE
Second Line	:	DEPT. OF ANESTHESIOLOGY, EMORY CRAWFORD LONG HOSP
City	:	ATLANTA
State	:	GA
Zip	:	30308-2247
Country	:	US
Telephone Number	:	404-686-2316
Fax Number	:	404-686-4949

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	03/09/2006
Last Update Date	:	07/08/2007

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Directions to “ DR. JAMES ALEXANDER DOLAK M.D., PH.D.” Practice Location

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