Healthcare Provider Details

I. General information

NPI: 1053717850
Provider Name (Legal Business Name): DEENA ALTMAN SPITAL PHYSICIAN ASSISTANT
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 11/06/2014
Last Update Date: 09/01/2026
Certification Date: 09/01/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5881 GLENRIDGE DR STE 250
SANDY SPRINGS GA
30328-6169
US

IV. Provider business mailing address

5881 GLENRIDGE DR STE 250
SANDY SPRINGS GA
30328-6169
US

V. Phone/Fax

Practice location:
  • Phone: 770-370-7188
  • Fax: 770-370-7400
Mailing address:
  • Phone: 404-273-1257
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363A00000X
TaxonomyPhysician Assistant
License Number7331
License Number StateGA
# 2
Primary TaxonomyN
Taxonomy Code363AM0700X
TaxonomyMedical Physician Assistant
License Number7331
License Number StateGA
# 3
Primary TaxonomyN
Taxonomy Code2084P0800X
TaxonomyPsychiatry Physician
License Number7331
License Number StateGA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: