Healthcare Provider Details
I. General information
NPI: 1881063618
Provider Name (Legal Business Name): REPRODUCTIVE ENDOCRINOLOGY AND INFERTILITY GROUP, INC.
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 09/22/2015
Last Update Date: 09/22/2015
Certification Date:
Deactivation Date:
Reactivation Date:
III. Provider practice location address
2001 PEACHTREE RD NE SUITE 650
ATLANTA GA
30309-1476
US
IV. Provider business mailing address
1125 OXFORD RD NE
ATLANTA GA
30306-2607
US
V. Phone/Fax
- Phone: 404-370-1817
- Fax:
- Phone: 404-370-1817
- Fax:
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 207VE0102X |
| Taxonomy | Reproductive Endocrinology Physician |
| License Number | 037844 |
| License Number State | GA |
VIII. Authorized Official
Name: DR.
CAROLYN
R
KAPLAN
Title or Position: PHYSICIAN OWNER
Credential: M.D.
Phone: 404-370-1817