Healthcare Provider Details

I. General information

NPI: 1083794184
Provider Name (Legal Business Name): ATLANTA CENTER FOR REPRODUCTIVE MEDICINE
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/16/2006
Last Update Date: 07/07/2021
Certification Date: 07/06/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5909 PEACHTREE DUNWOODY RD NE SUITE 720
ATLANTA GA
30328-8102
US

IV. Provider business mailing address

5909 PEACHTREE DUNWOODY RD STE 600
ATLANTA GA
30328-8101
US

V. Phone/Fax

Practice location:
  • Phone: 770-928-2276
  • Fax:
Mailing address:
  • Phone: 770-928-2276
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code261QA1903X
TaxonomyAmbulatory Surgical Clinic/Center
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code207VE0102X
TaxonomyReproductive Endocrinology Physician
License Number
License Number State

VIII. Authorized Official

Name: MICHAEL OSBORNE
Title or Position: COO
Credential:
Phone: 678-646-6871