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General NPI Number Information
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NPI Number | 1346437217
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Entity Type | Organization
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Legal Business Name | SURGICAL ARTS, P.C
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Dates
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Enumeration Date | 09/25/2007
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Last Update Date | 09/25/2007
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Provider Practice Location Address
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Address Line | 598 NANCY ST NW SUITE 250
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City | MARIETTA
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State | GA
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Zip | 30060-1362
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Country | US
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Telephone | 770-428-3713
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Fax | 770-426-0730
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Provider Business Mailing Address
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Address Line | 598 NANCY ST NW SUITE 250
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City | MARIETTA
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State | GA
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Zip | 30060-1362
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Country | US
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Telephone | 770-428-3713
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Fax | 770-426-0730
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Authorized Official
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Title or Position | PRESIDENT
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Name | DR. ROBERT A UNDERWOOD
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Credential | M.D.
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Telephone | 770-428-3713
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 174400000X
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Taxonomy Name | Specialist
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License Number | 049950
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License Number State | GA
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