Healthcare Provider Details

I. General information

NPI: 1093278939
Provider Name (Legal Business Name): SEW SURGICAL ASSISTING LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 04/08/2019
Last Update Date: 10/20/2023
Certification Date: 10/20/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

28 WHITE OAK DR SE
CARTERSVILLE GA
30121-2960
US

IV. Provider business mailing address

28 WHITE OAK DR SE
CARTERSVILLE GA
30121-2960
US

V. Phone/Fax

Practice location:
  • Phone: 267-776-5728
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code246ZC0007X
TaxonomySurgical Assistant
License Number
License Number State

VIII. Authorized Official

Name: MRS. ROSLYN CANARY CHAPMAN
Title or Position: SURGICAL ASSIST
Credential: CSFA
Phone: 267-776-5728