Healthcare Provider Details

I. General information

NPI: 1639154214
Provider Name (Legal Business Name): ALAN G SUNSHINE MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 12/07/2005
Last Update Date: 06/15/2015
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1800 HOWELL MILL RD NW SUITE 600
ATLANTA GA
30318-2538
US

IV. Provider business mailing address

550 PEACHTREE ST NE SUITE 1600
ATLANTA GA
30308-2208
US

V. Phone/Fax

Practice location:
  • Phone: 404-351-9512
  • Fax: 404-351-9815
Mailing address:
  • Phone: 404-881-1094
  • Fax: 404-881-1249

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207RG0100X
TaxonomyGastroenterology Physician
License Number28904
License Number StateGA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: