Healthcare Provider Details

I. General information

NPI: 1356591937
Provider Name (Legal Business Name): OB/GYN WOMEN SPECIALISTS OF GEORGIA, PC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/19/2008
Last Update Date: 09/19/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3951 SNAPFINGER PKWY SUITE 350
DECATUR GA
30035-3202
US

IV. Provider business mailing address

3951 SNAPFINGER PKWY SUITE 350
DECATUR GA
30035-3202
US

V. Phone/Fax

Practice location:
  • Phone: 404-284-5498
  • Fax: 404-284-3855
Mailing address:
  • Phone: 404-284-5498
  • Fax: 404-284-3855

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code173000000X
TaxonomyLegal Medicine
License Number031482
License Number StateGA

VIII. Authorized Official

Name: DR. VINTONNE A NAIDEN
Title or Position: PRESIDENT
Credential: M.D.
Phone: 404-284-5498