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General NPI Number Information
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NPI Number | 1487313839
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Entity Type | Organization
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Legal Business Name | BAUMRIND RETINA, LLC
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Dates
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Enumeration Date | 12/14/2021
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Last Update Date | 12/14/2021
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Provider Practice Location Address
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Address Line | 1425 ELLSWORTH INDUSTRIAL BLVD NW STE 36
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City | ATLANTA
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State | GA
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Zip | 30318-4154
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Country | US
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Telephone | 404-512-1590
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Fax |
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Provider Business Mailing Address
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Address Line | 1425 ELLSWORTH INDUSTRIAL BLVD NW STE 36
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City | ATLANTA
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State | GA
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Zip | 30318-4154
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Country | US
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Telephone | 404-512-1590
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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. BENJAMIN ROSEN BAUMRIND
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Credential | MD
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Telephone | 404-512-1590
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207W00000X
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Taxonomy Name | Ophthalmology Physician
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License Number |
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License Number State |
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