Healthcare Provider Details

I. General information

NPI: 1437326071
Provider Name (Legal Business Name): GREATER ATLANTA ANESTHESIA SPECIALISTS PC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/13/2008
Last Update Date: 07/21/2022
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

550 PEACHTREE ST NE SUITE 1750
ATLANTA GA
30308-2247
US

IV. Provider business mailing address

PO BOX 102079
ATLANTA GA
30368-2079
US

V. Phone/Fax

Practice location:
  • Phone: 404-881-8800
  • Fax: 404-881-8914
Mailing address:
  • Phone: 770-751-2623
  • Fax: 770-751-2609

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207L00000X
TaxonomyAnesthesiology Physician
License Number
License Number StateGA
# 2
Primary TaxonomyN
Taxonomy Code207LP2900X
TaxonomyPain Medicine (Anesthesiology) Physician
License Number
License Number StateGA
# 3
Primary TaxonomyN
Taxonomy Code363L00000X
TaxonomyNurse Practitioner
License Number
License Number StateGA
# 4
Primary TaxonomyN
Taxonomy Code367500000X
TaxonomyCertified Registered Nurse Anesthetist
License Number
License Number StateGA
# 5
Primary TaxonomyN
Taxonomy Code367H00000X
TaxonomyAnesthesiologist Assistant
License Number
License Number StateGA

VIII. Authorized Official

Name: STEVEN MICHAEL WALSH
Title or Position: PRESIDENT
Credential: MD
Phone: 770-751-2623