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General NPI Number Information
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NPI Number | 1366492282
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Entity Type | Organization
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Legal Business Name | ATLANTA DIABETES ASSOCIATES
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Dates
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Enumeration Date | 05/11/2006
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Last Update Date | 06/19/2025
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Provider Practice Location Address
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Address Line | 1800 HOWELL MILL RD NW SUITE 450
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City | ATLANTA
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State | GA
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Zip | 30318-2538
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Country | US
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Telephone | 404-355-4393
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Fax | 404-609-7622
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Provider Business Mailing Address
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Address Line | 1800 HOWELL MILL RD NW SUITE 450
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City | ATLANTA
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State | GA
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Zip | 30318-2538
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Country | US
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Telephone | 404-355-4393
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Fax | 404-609-7648
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Authorized Official
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Title or Position | PRESIDENT/OWNER
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Name | BRUCE WELSH BODE
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Credential | MD
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Telephone | 404-355-4393
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207RE0101X
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Taxonomy Name | Endocrinology, Diabetes & Metabolism Physician
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License Number |
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License Number State | GA
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