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General NPI Number Information
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NPI Number | 1164697892
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Entity Type | Organization
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Legal Business Name | ATLANTA UROLOGY ASSOCIATES, P.C.
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Dates
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Enumeration Date | 04/24/2008
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Last Update Date | 07/31/2009
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Provider Practice Location Address
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Address Line | 550 PEACHTREE ST NE SUITE 1635
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City | ATLANTA
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State | GA
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Zip | 30308-2247
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Country | US
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Telephone | 404-525-5567
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Fax | 404-880-0192
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Provider Business Mailing Address
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Address Line | PO BOX 54676
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City | ATLANTA
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State | GA
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Zip | 30308-0676
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Country | US
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Telephone | 404-525-5567
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Fax | 404-880-0192
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Authorized Official
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Title or Position | PHYSICIAN
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Name | DR. BRUCE STEIN
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Credential | M.D.
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Telephone | 404-525-5567
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 208800000X
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Taxonomy Name | Urology Physician
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License Number | 029535
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License Number State | GA
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