Healthcare Provider Details

I. General information

NPI: 1023403177
Provider Name (Legal Business Name): CHRISTOPHER SCELSI D.O.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/04/2015
Last Update Date: 11/01/2022
Certification Date: 11/01/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5605 GLENRIDGE DR STE 325
ATLANTA GA
30342-1301
US

IV. Provider business mailing address

5605 GLENRIDGE DR STE 325
ATLANTA GA
30342-1301
US

V. Phone/Fax

Practice location:
  • Phone: 404-252-4709
  • Fax:
Mailing address:
  • Phone: 404-252-4709
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code2085N0700X
TaxonomyNeuroradiology Physician
License Number88644
License Number StateGA
# 2
Primary TaxonomyN
Taxonomy Code390200000X
TaxonomyStudent in an Organized Health Care Education/Training Program
License Number
License Number State
# 3
Primary TaxonomyY
Taxonomy Code2085R0202X
TaxonomyDiagnostic Radiology Physician
License Number88644
License Number StateGA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: