Healthcare Provider Details

I. General information

NPI: 1225456775
Provider Name (Legal Business Name): ERIC BLACK-MAIER MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/02/2014
Last Update Date: 01/15/2025
Certification Date: 01/15/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

95 COLLIER RD NW STE 6000
ATLANTA GA
30309-1972
US

IV. Provider business mailing address

95 COLLIER RD NW STE 6000
ATLANTA GA
30309-1972
US

V. Phone/Fax

Practice location:
  • Phone: 404-605-2888
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License Number101839
License Number StateGA
# 2
Primary TaxonomyN
Taxonomy Code207RC0000X
TaxonomyCardiovascular Disease Physician
License NumberMD24975
License Number StateME
# 3
Primary TaxonomyN
Taxonomy Code207RC0000X
TaxonomyCardiovascular Disease Physician
License Number101839
License Number StateGA
# 4
Primary TaxonomyY
Taxonomy Code207RC0001X
TaxonomyClinical Cardiac Electrophysiology Physician
License Number101839
License Number StateGA
# 5
Primary TaxonomyN
Taxonomy Code207RC0001X
TaxonomyClinical Cardiac Electrophysiology Physician
License NumberMD24975
License Number StateME

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: