Healthcare Provider Details

I. General information

NPI: 1043291826
Provider Name (Legal Business Name): PETER WALTER BARRETT MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 11/09/2005
Last Update Date: 04/10/2018
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

95 COLLIER ROAD, NW SUITE 5015
ATLANTA GA
30309
US

IV. Provider business mailing address

275 COLLIER ROAD, NW SUITE 500
ATLANTA GA
30309-1711
US

V. Phone/Fax

Practice location:
  • Phone: 404-605-5699
  • Fax: 404-355-4235
Mailing address:
  • Phone: 404-605-2800
  • Fax: 404-351-5983

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code208G00000X
TaxonomyThoracic Surgery (Cardiothoracic Vascular Surgery) Physician
License Number069372
License Number StateGA
# 2
Primary TaxonomyY
Taxonomy Code2086S0102X
TaxonomySurgical Critical Care Physician
License Number069372
License Number StateGA
# 3
Primary TaxonomyN
Taxonomy Code207RC0200X
TaxonomyCritical Care Medicine (Internal Medicine) Physician
License Number069372
License Number StateGA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: