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General NPI Number Information
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NPI Number | 1487780599
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Entity Type | Organization
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Legal Business Name | RHEUMATOLOGY OF NORTH ATLANTA
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Dates
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Enumeration Date | 02/25/2007
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Last Update Date | 08/22/2020
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Provider Practice Location Address
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Address Line | 4790 SUGARLOAF PKWY SUITE 100
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City | LAWRENCEVILLE
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State | GA
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Zip | 30044-6985
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Country | US
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Telephone | 678-226-2600
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Fax |
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Provider Business Mailing Address
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Address Line | PO BOX 942449
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City | ATLANTA
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State | GA
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Zip | 31141-2449
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Country | US
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Telephone | 678-226-2600
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Fax | 678-226-2635
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Authorized Official
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Title or Position | PRESIDENT
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Name | ROEL NOLIDO QUERUBIN
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Credential | M.D.
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Telephone | 678-226-2600
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207RR0500X
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Taxonomy Name | Rheumatology Physician
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License Number | 043112
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License Number State | GA
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