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General NPI Number Information
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NPI Number | 1073207007
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Entity Type | Organization
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Legal Business Name | GEORGIA ENDOVASCULAR ASSOCIATES, LLC
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Dates
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Enumeration Date | 06/05/2023
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Last Update Date | 05/22/2025
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Provider Practice Location Address
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Address Line | 3225 CUMBERLAND BLVD SE STE 520
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City | ATLANTA
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State | GA
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Zip | 30339-6407
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Country | US
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Telephone | 713-575-3686
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Fax | 713-575-3688
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Provider Business Mailing Address
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Address Line | 3225 CUMBERLAND BLVD SE STE 520
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City | ATLANTA
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State | GA
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Zip | 30339-6407
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Country | US
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Telephone | 678-915-2000
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Fax | 404-868-3363
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Authorized Official
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Title or Position | PRACTICE MANAGER
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Name | AKILAH SOLOMON
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Credential |
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Telephone | 678-915-2000
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 2085R0204X
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Taxonomy Name | Vascular & Interventional Radiology Physician
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License Number |
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License Number State |
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