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General NPI Number Information
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NPI Number | 1215149612
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Entity Type | Organization
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Legal Business Name | COMPREHENSIVE GASTROENTEROLOGY OF GEORGIA, LLC
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Dates
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Enumeration Date | 05/06/2007
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Last Update Date | 08/22/2020
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Provider Practice Location Address
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Address Line | 960 JOHNSON FERRY RD NE SUITE 415
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City | ATLANTA
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State | GA
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Zip | 30342-1631
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Country | US
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Telephone | 404-252-7910
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Fax |
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Provider Business Mailing Address
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Address Line | PO BOX 723428
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City | ATLANTA
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State | GA
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Zip | 31139-0428
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Country | US
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Telephone | 404-252-7910
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | DR. ERIC STEINBERG
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Credential | MD
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Telephone | 404-252-7910
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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 | 34955
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License Number State | GA
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