Healthcare Provider Details

I. General information

NPI: 1205875242
Provider Name (Legal Business Name): ELLYN M MESHEL M.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: ELLYN M SCHREIBMAN M.D.

II. Dates (important events)

Enumeration Date: 06/05/2006
Last Update Date: 08/21/2018
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3495 PIEDMONT RD NE
ATLANTA GA
30305
US

IV. Provider business mailing address

3495 PIEDMONT RD NE
ATLANTA GA
30305-1717
US

V. Phone/Fax

Practice location:
  • Phone: 404-364-7285
  • Fax:
Mailing address:
  • Phone: 404-364-7285
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207P00000X
TaxonomyEmergency Medicine Physician
License Number42000-020
License Number StateWI
# 2
Primary TaxonomyN
Taxonomy Code207P00000X
TaxonomyEmergency Medicine Physician
License Number29433
License Number StateSC
# 3
Primary TaxonomyY
Taxonomy Code207P00000X
TaxonomyEmergency Medicine Physician
License Number069209
License Number StateGA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: