Healthcare Provider Details

I. General information

NPI: 1922047893
Provider Name (Legal Business Name): PIEDMONT COLORECTAL ASSOCIATES, PC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/06/2006
Last Update Date: 05/16/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

35 COLLIER RD NW SUITE 475
ATLANTA GA
30309-1613
US

IV. Provider business mailing address

35 COLLIER RD NW SUITE 475
ATLANTA GA
30309-1613
US

V. Phone/Fax

Practice location:
  • Phone: 404-351-7900
  • Fax: 404-351-7901
Mailing address:
  • Phone: 404-351-7900
  • Fax: 404-351-7901

VI. Provider taxonomy

Scope of Practice (Provider specialty)

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

VIII. Authorized Official

Name: MRS. ANJELICA ALSTON
Title or Position: PRACTICE MANAGER
Credential:
Phone: 404-351-7900