Healthcare Provider Details

I. General information

NPI: 1982732202
Provider Name (Legal Business Name): ELISSA MEITES MD, MPH
Entity Type: Individual
Gender:
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 02/28/2007
Last Update Date: 04/30/2024
Certification Date: 04/30/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1600 CLIFTON RD NE
ATLANTA GA
30329-4018
US

IV. Provider business mailing address

1600 CLIFTON RD NE
ATLANTA GA
30329-4018
US

V. Phone/Fax

Practice location:
  • Phone: 800-232-4636
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2083P0901X
TaxonomyPublic Health & General Preventive Medicine Physician
License Number061916
License Number StateGA
# 2
Primary TaxonomyN
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License NumberA98608
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: