Healthcare Provider Details

I. General information

NPI: 1497940696
Provider Name (Legal Business Name): ERIKA R HALES MD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/11/2007
Last Update Date: 01/07/2022
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3550 PRESTON RIDGE RD
ALPHARETTA GA
30005-3821
US

IV. Provider business mailing address

3495 PIEDMONT RD NE NINE PIEDMONT ROAD,
ATLANTA GA
30305-1717
US

V. Phone/Fax

Practice location:
  • Phone: 917-687-1462
  • Fax:
Mailing address:
  • Phone: 404-364-7070
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code208000000X
TaxonomyPediatrics Physician
License Number432728
License Number StatePA
# 2
Primary TaxonomyY
Taxonomy Code208000000X
TaxonomyPediatrics Physician
License Number062703
License Number StateGA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: