Healthcare Provider Details

I. General information

NPI: 1649504903
Provider Name (Legal Business Name): CURTIS T MONROE CSA
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 09/18/2009
Last Update Date: 09/23/2025
Certification Date: 09/23/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

10945 STATE BRIDGE RD STE 401-322
ALPHARETTA GA
30022-8164
US

IV. Provider business mailing address

10945 STATE BRIDGE RD STE 401-322
ALPHARETTA GA
30022-8164
US

V. Phone/Fax

Practice location:
  • Phone: 770-985-4257
  • Fax: 770-985-4258
Mailing address:
  • Phone: 410-499-8868
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code246ZC0007X
TaxonomySurgical Assistant
License Number3462
License Number StateGA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: