Healthcare Provider Details

I. General information

NPI: 1144524554
Provider Name (Legal Business Name): ATLANTA BIRTH CENTER
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 12/28/2010
Last Update Date: 12/28/2010
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

285 BOULEVARD NE SUITE 520
ATLANTA GA
30312-4205
US

IV. Provider business mailing address

550 PEACHTREE ST NE SUITE 1165
ATLANTA GA
30308-2208
US

V. Phone/Fax

Practice location:
  • Phone: 404-941-2393
  • Fax: 404-941-2419
Mailing address:
  • Phone: 404-941-2393
  • Fax: 404-941-2419

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207V00000X
TaxonomyObstetrics & Gynecology Physician
License Number041733
License Number StateGA
# 2
Primary TaxonomyN
Taxonomy Code207VM0101X
TaxonomyMaternal & Fetal Medicine Physician
License Number041733
License Number StateGA

VIII. Authorized Official

Name: MRS. FELICIA SPENCER
Title or Position: OFFICE MANAGER
Credential: BA,RMC
Phone: 404-941-2393