Healthcare Provider Details

I. General information

NPI: 1962910679
Provider Name (Legal Business Name): AMERICAN PROFESSIONAL ASSOCIATES LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 01/16/2018
Last Update Date: 01/16/2018
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

33 UPPER RIVERDALE RD SW STE 105
RIVERDALE GA
30274-2642
US

IV. Provider business mailing address

3330 PRESTON RIDGE RD STE 300
ALPHARETTA GA
30005-4509
US

V. Phone/Fax

Practice location:
  • Phone: 404-522-6569
  • Fax: 404-522-8265
Mailing address:
  • Phone: 770-350-0126
  • Fax: 770-512-8937

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2085R0001X
TaxonomyRadiation Oncology Physician
License Number
License Number State

VIII. Authorized Official

Name: RAMILA PATEL
Title or Position: CREDENTIALING SPECIALIST
Credential:
Phone: 770-255-7442