Healthcare Provider Details

I. General information

NPI: 1477000271
Provider Name (Legal Business Name): ARIANA METCHIK M.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 09/09/2016
Last Update Date: 07/28/2023
Certification Date: 07/28/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

69 JESSE HILL JR DR SE BLDG 3
ATLANTA GA
30303-3033
US

IV. Provider business mailing address

69 JESSE HILL JR DR SE BLDG 3
ATLANTA GA
30303-3033
US

V. Phone/Fax

Practice location:
  • Phone: 404-251-8915
  • Fax: 404-523-3931
Mailing address:
  • Phone: 404-251-8915
  • Fax: 404-523-3931

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code390200000X
TaxonomyStudent in an Organized Health Care Education/Training Program
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code2086S0127X
TaxonomyTrauma Surgery Physician
License Number96466
License Number StateGA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: