Healthcare Provider Details

I. General information

NPI: 1548252042
Provider Name (Legal Business Name): COMPREHENSIVE ORTHOPAEDIC GROUP
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/19/2005
Last Update Date: 08/22/2020
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1100 NORTHSIDE FORSYTH DR SUITE 400
CUMMING GA
30041-6012
US

IV. Provider business mailing address

1100 NORTHSIDE FORSYTH DR SUITE 400
CUMMING GA
30041-6012
US

V. Phone/Fax

Practice location:
  • Phone: 770-888-1976
  • Fax: 770-888-8368
Mailing address:
  • Phone: 770-888-1976
  • Fax: 770-888-8368

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207X00000X
TaxonomyOrthopaedic Surgery Physician
License Number
License Number State

VIII. Authorized Official

Name: PAM ZUBER
Title or Position: BUSINESS OFFICE MANAGER
Credential:
Phone: 770-888-1976