Healthcare Provider Details

I. General information

NPI: 1346290806
Provider Name (Legal Business Name): ALAN B. FISHMAN MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/12/2006
Last Update Date: 11/02/2010
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5673 PEACHTREE DUNWOODY RD NE
ATLANTA GA
30342-1770
US

IV. Provider business mailing address

550 PEACHTREE STREET SUITE 1550
ATLANTA GA
30308
US

V. Phone/Fax

Practice location:
  • Phone: 404-256-8500
  • Fax: 404-256-8506
Mailing address:
  • Phone: 404-892-2131
  • Fax: 404-215-9222

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207RR0500X
TaxonomyRheumatology Physician
License Number023154
License Number StateGA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: