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General NPI Number Information
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NPI Number | 1427503986
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Entity Type | Organization
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Legal Business Name | 404 GYNECOLOGY LLC
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Dates
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Enumeration Date | 08/24/2016
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Last Update Date | 11/15/2016
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Provider Practice Location Address
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Address Line | 755 MOUNT VERNON HWY NE SUITE 120
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City | SANDY SPRINGS
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State | GA
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Zip | 30328-4274
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Country | US
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Telephone | 770-500-5600
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Fax | 404-393-6788
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Provider Business Mailing Address
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Address Line | 755 MOUNT VERNON HWY NE SUITE 120
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City | SANDY SPRINGS
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State | GA
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Zip | 30328-4274
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Country | US
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Telephone | 770-500-5600
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Fax | 404-393-6788
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Authorized Official
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Title or Position | PRACTICE ADMIN
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Name | MR. SEAN M MCGREGOR
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Credential |
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Telephone | 770-500-5600
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207VG0400X
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Taxonomy Name | Gynecology Physician
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License Number |
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License Number State |
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