Healthcare Provider Details

I. General information

NPI: 1124064118
Provider Name (Legal Business Name): AGA, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/20/2006
Last Update Date: 04/05/2022
Certification Date: 12/23/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

550 PEACHTREE ST NE SUITE 1620
ATLANTA GA
30308-2209
US

IV. Provider business mailing address

1355 PEACHTREE ST NE STE 1600
ATLANTA GA
30309-3276
US

V. Phone/Fax

Practice location:
  • Phone: 404-885-7701
  • Fax: 404-885-7777
Mailing address:
  • Phone: 404-888-7575
  • Fax: 404-885-7777

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207RI0008X
TaxonomyHepatology Physician
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code207RG0100X
TaxonomyGastroenterology Physician
License Number
License Number State

VIII. Authorized Official

Name: JUNG WHUN SUH
Title or Position: CHIEF MEDICAL OFFICER
Credential: MD
Phone: 404-881-1094