Healthcare Provider Details

I. General information

NPI: 1821011503
Provider Name (Legal Business Name): CARDIAC DISEASE SPECIALISTS
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/25/2006
Last Update Date: 08/22/2020
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

95 COLLIER RD NW SUITE 2035
ATLANTA GA
30309-1796
US

IV. Provider business mailing address

1801 PEACHTREE ST SUITE 250
ATLANTA GA
30309-1895
US

V. Phone/Fax

Practice location:
  • Phone: 404-355-9815
  • Fax: 404-350-0529
Mailing address:
  • Phone: 404-352-1611
  • Fax: 404-352-7107

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code174400000X
TaxonomySpecialist
License Number
License Number StateGA

VIII. Authorized Official

Name: MRS. BILLIE R HAMILTON
Title or Position: OFFICE MANAGER
Credential:
Phone: 404-352-1611