Healthcare Provider Details

I. General information

NPI: 1407005986
Provider Name (Legal Business Name): ATLANTA MEDICAL CENTER
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/09/2008
Last Update Date: 09/11/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

303 PARKWAY DR NE
ATLANTA GA
30312-1212
US

IV. Provider business mailing address

303 PARKWAY DR NE
ATLANTA GA
30312-1212
US

V. Phone/Fax

Practice location:
  • Phone: 404-265-4919
  • Fax:
Mailing address:
  • Phone: 404-265-4919
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code282E00000X
TaxonomyLong Term Care Hospital
License Number
License Number StateGA

VIII. Authorized Official

Name: DR. MIRIAM PARKER
Title or Position: INTERNAL MEDICINE PROGRAM DIRECTOR
Credential:
Phone: 404-265-4919