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General NPI Number Information
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NPI Number | 1366576100
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Entity Type | Organization
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Legal Business Name | GREATER ATLANTA OBGYN ASSOCIATES
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Dates
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Enumeration Date | 03/15/2007
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Last Update Date | 08/22/2020
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Provider Practice Location Address
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Address Line | 6285 SHANNON PKWY
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City | UNION CITY
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State | GA
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Zip | 30291-2081
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Country | US
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Telephone | 770-964-4142
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Fax | 770-964-4575
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Provider Business Mailing Address
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Address Line | 6285 SHANNON PKWY
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City | UNION CITY
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State | GA
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Zip | 30291-2081
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Country | US
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Telephone | 770-964-4142
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Fax | 770-964-4575
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Authorized Official
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Title or Position | CEO-PYSICIAN
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Name | DR. VELVET LAVERN MCDONALD
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Credential | M.D.
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Telephone | 770-964-4142
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207V00000X
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Taxonomy Name | Obstetrics & Gynecology Physician
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License Number | 036819
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License Number State | GA
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