Healthcare Provider Details

I. General information

NPI: 1750326617
Provider Name (Legal Business Name): EMORY UNIVERSITY HEALTH SERVICES
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/17/2006
Last Update Date: 08/22/2020
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1525 CLIFTON RD NE ROOM 272
ATLANTA GA
30322-4200
US

IV. Provider business mailing address

1525 CLIFTON RD NE ROOM 272
ATLANTA GA
30322-4200
US

V. Phone/Fax

Practice location:
  • Phone: 404-712-8652
  • Fax: 404-727-3859
Mailing address:
  • Phone: 404-712-8652
  • Fax: 404-727-3859

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QS1000X
TaxonomyStudent Health Clinic/Center
License Number050962
License Number StateGA

VIII. Authorized Official

Name: DR. MICHAEL JOSEPH HUEY
Title or Position: EXECUTIVE DIRECTOR
Credential: M.D.
Phone: 404-712-8652