Healthcare Provider Details
I. General information
NPI: 1447357868
Provider Name (Legal Business Name): CHILDREN'S ANESTHESIOLOGY CONSULTANTS, PC
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 09/20/2006
Last Update Date: 08/22/2020
Certification Date:
Deactivation Date:
Reactivation Date:
III. Provider practice location address
993-D JOHNSON FERRY RD. SUITE300
ATLANTA GA
30342-0858
US
IV. Provider business mailing address
PO BOX 420858
ATLANTA GA
30342-0858
US
V. Phone/Fax
- Phone: 404-250-1153
- Fax:
- Phone: 404-250-1153
- Fax: 404-303-0317
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 207L00000X |
| Taxonomy | Anesthesiology Physician |
| License Number | 0033485 |
| License Number State | GA |
VIII. Authorized Official
Name: DR.
MICHAEL
STEPHEN
WEINSTEIN
Title or Position: PRESIDENT
Credential: M.D
Phone: 404-250-1153