Healthcare Provider Details

I. General information

NPI: 1356609044
Provider Name (Legal Business Name): ALEX E. RIKHTER,M.D. PC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/01/2012
Last Update Date: 05/01/2012
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3867 ROSWELL RD SUITE 100
ATLANTA GA
30342-4451
US

IV. Provider business mailing address

3867 ROSWELL RD SUITE 100
ATLANTA GA
30342-4451
US

V. Phone/Fax

Practice location:
  • Phone: 678-904-5611
  • Fax: 404-207-1873
Mailing address:
  • Phone: 678-904-5611
  • Fax: 404-207-1873

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QP2300X
TaxonomyPrimary Care Clinic/Center
License Number44070
License Number StateGA

VIII. Authorized Official

Name: DR. ALEX E RIKHTER
Title or Position: MEDICAL DIRECTOR/PRESIDENT
Credential: M.D.
Phone: 678-904-5611