Healthcare Provider Details

I. General information

NPI: 1871755645
Provider Name (Legal Business Name): ANNE ELISA COSSU M.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 07/01/2008
Last Update Date: 05/02/2025
Certification Date: 05/02/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2405 HENDERSON MILL RD NE
ATLANTA GA
30345-2137
US

IV. Provider business mailing address

2405 HENDERSON MILL RD NE
ATLANTA GA
30345-2137
US

V. Phone/Fax

Practice location:
  • Phone: 917-543-7721
  • Fax:
Mailing address:
  • Phone: 917-543-7721
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207L00000X
TaxonomyAnesthesiology Physician
License Number01076698A
License Number StateIN
# 2
Primary TaxonomyN
Taxonomy Code207L00000X
TaxonomyAnesthesiology Physician
License NumberT2582
License Number StateTX
# 3
Primary TaxonomyY
Taxonomy Code207LC0200X
TaxonomyCritical Care Medicine (Anesthesiology) Physician
License Number92183
License Number StateGA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: