Healthcare Provider Details

I. General information

NPI: 1669659801
Provider Name (Legal Business Name): EMORY UNIVERSITY SCHOOL OF MEDICINE
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 01/30/2008
Last Update Date: 01/30/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2015 UPPER GATE DR NE
ATLANTA GA
30322-1014
US

IV. Provider business mailing address

1319 WESTCHESTER RDG NE
ATLANTA GA
30329-2483
US

V. Phone/Fax

Practice location:
  • Phone: 404-727-5406
  • Fax:
Mailing address:
  • Phone: 404-228-6627
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code282NC2000X
TaxonomyChildren's Hospital
License Number002131
License Number StateGA

VIII. Authorized Official

Name: DR. PAUL SPEARMAN
Title or Position: PROGRAM DIRECTOR
Credential: MD
Phone: 404-727-5642