Healthcare Provider Details
I. General information
NPI: 1831356617
Provider Name (Legal Business Name): AMERICAN ACCESS CARE OF ATLANTA LLC
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 05/20/2008
Last Update Date: 09/22/2025
Certification Date: 09/22/2025
Deactivation Date:
Reactivation Date:
III. Provider practice location address
250 E PONCE DE LEON AVE SUITE 100
DECATUR GA
30030-3440
US
IV. Provider business mailing address
PO BOX 415250
BOSTON MA
02241-5250
US
V. Phone/Fax
- Phone: 404-377-9171
- Fax: 404-377-9172
- Phone: 610-644-8900
- Fax: 484-924-0053
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | N |
| Taxonomy Code | 2085R0204X |
| Taxonomy | Vascular & Interventional Radiology Physician |
| License Number | |
| License Number State | |
| # 2 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 207RN0300X |
| Taxonomy | Nephrology Physician |
| License Number | |
| License Number State | |
VIII. Authorized Official
Name: DR.
GREGG
ARTHUR
MILLER
Title or Position: AUTHORIZED OFFICIAL
Credential: MD
Phone: 717-515-4048