Healthcare Provider Details

I. General information

NPI: 1013092956
Provider Name (Legal Business Name): CARDIAC DISEASE SPECIALISTS, PC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/26/2006
Last Update Date: 11/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1938 PEACHTREE RD NW STE 412
ATLANTA GA
30309-1267
US

IV. Provider business mailing address

275 COLLIER RD NW STE 300
ATLANTA GA
30309-1704
US

V. Phone/Fax

Practice location:
  • Phone: 404-351-3231
  • Fax: 404-351-3167
Mailing address:
  • Phone: 404-355-9815
  • Fax: 404-350-0529

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code207RI0011X
TaxonomyInterventional Cardiology Physician
License Number
License Number State
# 3
Primary TaxonomyY
Taxonomy Code207RC0000X
TaxonomyCardiovascular Disease Physician
License Number
License Number State

VIII. Authorized Official

Name: HARVEY N SACKS
Title or Position: PRESIDENT
Credential: MD
Phone: 404-355-9815