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General NPI Number Information
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NPI Number | 1497836456
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Entity Type | Organization
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Legal Business Name | ARTHRITIS RESEARCH & TREATMENT CENTER
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Dates
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Enumeration Date | 10/18/2006
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Last Update Date | 06/01/2010
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Provider Practice Location Address
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Address Line | 1101 HOSPITAL DR SUITE 200
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City | STOCKBRIDGE
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State | GA
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Zip | 30281-9075
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Country | US
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Telephone | 678-289-5488
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Fax | 678-289-5489
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Provider Business Mailing Address
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Address Line | 1101 HOSPITAL DRIVE SUITE 200
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City | STOCKBRIDGE
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State | GA
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Zip | 30281-9075
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Country | US
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Telephone | 678-289-5488
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Fax | 678-289-5489
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Authorized Official
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Title or Position | PRESIDENT
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Name | MARIA FONDAL
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Credential | MD
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Telephone | 678-289-5488
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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 | 045463
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License Number State | GA
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