Healthcare Provider Details

I. General information

NPI: 1912225392
Provider Name (Legal Business Name): MICHAEL GEORGE PFEIL NEIMKIN MD
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 05/11/2010
Last Update Date: 03/17/2018
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3280 HOWELL MILL RD NW SUITE 321
ATLANTA GA
30327-4111
US

IV. Provider business mailing address

3280 HOWELL MILL RD NW STE 321
ATLANTA GA
30327-4109
US

V. Phone/Fax

Practice location:
  • Phone: 404-946-8323
  • Fax:
Mailing address:
  • Phone: 205-222-2611
  • Fax: 404-996-2480

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207W00000X
TaxonomyOphthalmology Physician
License Number2014008993
License Number StateMO
# 2
Primary TaxonomyN
Taxonomy Code207W00000X
TaxonomyOphthalmology Physician
License Number76141
License Number StateGA
# 3
Primary TaxonomyY
Taxonomy Code207WX0200X
TaxonomyOphthalmic Plastic and Reconstructive Surgery Physician
License Number76141
License Number StateGA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: