Healthcare Provider Details

I. General information

NPI: 1558418400
Provider Name (Legal Business Name): CHRISTOPHER ROBERT KUZNIAK MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 01/04/2007
Last Update Date: 08/24/2015
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

95 COLLIER RD NW SUITE 6015
ATLANTA GA
30309-1796
US

IV. Provider business mailing address

95 COLLIER RD NW SUITE 6015
ATLANTA GA
30309-1796
US

V. Phone/Fax

Practice location:
  • Phone: 404-355-4848
  • Fax: 404-351-8526
Mailing address:
  • Phone: 404-355-4848
  • Fax: 404-351-8526

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208600000X
TaxonomySurgery Physician
License Number64664
License Number StateGA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: