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General NPI Number Information
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NPI Number | 1497941991
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Entity Type | Organization
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Legal Business Name | CARDIOLOGY OF ATLANTA
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Dates
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Enumeration Date | 09/18/2007
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Last Update Date | 01/29/2008
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Provider Practice Location Address
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Address Line | 755 MOUNT VERNON HWY SUITE 530
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City | ATLANTA
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State | GA
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Zip | 30328-4274
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Country | US
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Telephone | 404-252-7970
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Fax | 404-250-0553
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Provider Business Mailing Address
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Address Line | 755 MOUNT VERNON HWY SUITE 530
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City | ATLANTA
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State | GA
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Zip | 30328-4274
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Country | US
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Telephone | 404-252-7970
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Fax | 404-250-0553
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Authorized Official
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Title or Position | SENIOR ADMINISTRATOR
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Name | MS. BRENDA MATHEWS
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Credential |
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Telephone | 404-252-7970
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207RC0000X
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Taxonomy Name | Cardiovascular Disease Physician
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License Number |
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License Number State |
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