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NPI Code Detail

MEDICARE: METRO ATLANTA ACCESS CENTER LLC

MEDICARE: METRO ATLANTA ACCESS CENTER LLC
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
1174400000XSpecialist
2207RN0300XNephrology Physician

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
11598755993OTHERGANPI
21730127945OTHERGANPI
3MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
41649345919OTHERGANPI

General Provider Information

NPI Number : 1982818951
Entity Type Code : Organization
Provider Name (Legal Business Name) : METRO ATLANTA ACCESS CENTER LLC
Provider Business Mailing Address
First Line : 3885 PRINCETON LAKES WAY SW
Second Line : SUITE 314
City : ATLANTA
State : GA
Zip : 30331-5589
Country : US
Telephone Number : 404-349-7770
Fax Number : 404-349-7778
Provider Business Practice Location Address
First Line : 3885 PRINCETON LAKES WAY SW
Second Line : SUITE 314
City : ATLANTA
State : GA
Zip : 30331-5589
Country : US
Telephone Number : 404-349-7770
Fax Number : 404-349-7778
Authorized Official
Title or Position : PRESIDENT - CHAIRMAN OF THE BOARD
Name : ANGUS C HOWARD JR.
Credential : MD
Telephone Number : 404-696-7300
Provider Enumeration Date : 05/09/2007
Last Update Date : 09/20/2011

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Directions to “METRO ATLANTA ACCESS CENTER LLC ” Practice Location

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