MEDICARE: LUNATE SURGERY CENTER

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	261QA1903X	Ambulatory Surgical Clinic/Center

General Provider Information

NPI Number	:	1932709490
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	LUNATE SURGERY CENTER

Provider Business Mailing Address
First Line	:	3968 FELTON HILL RD SW STE 100
Second Line	:
City	:	SMYRNA
State	:	GA
Zip	:	30082-3522
Country	:	US
Telephone Number	:	770-333-7888
Fax Number	:	770-333-7889

Provider Business Practice Location Address
First Line	:	6115 PEACHTREE DUNWOODY RD STE 230
Second Line	:
City	:	SANDY SPRINGS
State	:	GA
Zip	:	30328-5546
Country	:	US
Telephone Number	:	770-333-7888
Fax Number	:	770-333-7889

Authorized Official
Title or Position	:	CEO
Name	:	VIRALKUMAR PATEL
Credential	:	MD
Telephone Number	:	770-333-7888

Provider Enumeration Date	:	10/26/2020
Last Update Date	:	02/06/2024

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Directions to “LUNATE SURGERY CENTER ” Practice Location

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