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NPI Code Detail

MEDICARE: ATLANTA MIDTOWN GYNECOLOGY, INC

MEDICARE: ATLANTA MIDTOWN GYNECOLOGY, INC
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
1174400000XSpecialist046900GA

General Provider Information

NPI Number : 1871759951
Entity Type Code : Organization
Provider Name (Legal Business Name) : ATLANTA MIDTOWN GYNECOLOGY, INC
Provider Business Mailing Address
First Line : 842 N HIGHLAND AVE NE
Second Line : SUITE 250
City : ATLANTA
State : GA
Zip : 30306-4530
Country : US
Telephone Number : 404-685-8867
Fax Number : 404-685-8137
Provider Business Practice Location Address
First Line : 842 N HIGHLAND AVE NE
Second Line : SUITE 250
City : ATLANTA
State : GA
Zip : 30306-4530
Country : US
Telephone Number : 404-685-8867
Fax Number : 404-685-8137
Authorized Official
Title or Position : PRESIDENT
Name : DR. MICHAEL FREDERICK PERRY
Credential : M.D.
Telephone Number : 404-685-8867
Provider Enumeration Date : 07/29/2008
Last Update Date : 07/29/2008

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