Healthcare Provider Details

I. General information

NPI: 1174522478
Provider Name (Legal Business Name): STUART JAY TOPOROFF MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/19/2005
Last Update Date: 09/07/2016
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

6115 PEACHTREE DUNWOODY ROAD SUITE 300
SANDY SPRINGS GA
30328
US

IV. Provider business mailing address

6115 PEACHTREE DUNWOODY ROAD SUITE 300
SANDY SPRINGS GA
30328
US

V. Phone/Fax

Practice location:
  • Phone: 678-320-3600
  • Fax:
Mailing address:
  • Phone: 678-320-3600
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207RC0000X
TaxonomyCardiovascular Disease Physician
License Number015136
License Number StateGA
# 2
Primary TaxonomyN
Taxonomy Code207RI0011X
TaxonomyInterventional Cardiology Physician
License Number015136
License Number StateGA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: