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General NPI Number Information
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NPI Number | 1043547912
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Entity Type | Organization
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Legal Business Name | ATLANTA GASTROENTEROLOGY SPECIALISTS, PC
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Dates
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Enumeration Date | 11/12/2009
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Last Update Date | 07/19/2019
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Provider Practice Location Address
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Address Line | 4395 JOHNS CREEK PKWY STE 130
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City | SUWANEE
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State | GA
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Zip | 30024-6125
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Country | US
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Telephone | 678-357-0057
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Fax | 678-382-6406
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Provider Business Mailing Address
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Address Line | 4395 JOHNS CREEK PKWY STE 130
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City | SUWANEE
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State | GA
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Zip | 30024-6125
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Country | US
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Telephone | 678-957-0057
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Fax | 678-957-0047
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Authorized Official
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Title or Position | OWNER/PHYSICIAN
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Name | DR. BRUCE ANDREW SALZBERG
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Credential | M.D.
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Telephone | 678-957-0057
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207RG0100X
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Taxonomy Name | Gastroenterology Physician
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License Number | 029775
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License Number State | GA
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