Healthcare Provider Details

I. General information

NPI: 1649676156
Provider Name (Legal Business Name): AARON TOMER M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 11/10/2014
Last Update Date: 11/10/2014
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2 IVY PKWY NE
ATLANTA GA
30342-4241
US

IV. Provider business mailing address

2 IVY PKWY NE
ATLANTA GA
30342-4241
US

V. Phone/Fax

Practice location:
  • Phone: 470-255-0582
  • Fax: 404-233-2910
Mailing address:
  • Phone: 470-255-0582
  • Fax: 404-233-2910

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1744R1102X
TaxonomyResearch Study Specialist
License Number34066
License Number StateGA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: