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General NPI Number Information
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NPI Number | 1508222423
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Entity Type | Organization
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Legal Business Name | IDEAL GYNECOLOGY
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Dates
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Enumeration Date | 01/07/2016
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Last Update Date | 02/01/2017
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Provider Practice Location Address
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Address Line | 3200 DOWNWOOD CIR NW STE 220
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City | ATLANTA
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State | GA
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Zip | 30327-1611
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Country | US
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Telephone | 470-312-3696
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Fax |
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Provider Business Mailing Address
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Address Line | 3200 DOWNWOOD CIR NW STE 220
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City | ATLANTA
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State | GA
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Zip | 30327-1611
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Country | US
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Telephone | 470-312-3696
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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. LILLIAN SCHAPIRO
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Credential | M.D.
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Telephone | 404-550-4503
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261Q00000X
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Taxonomy Name | Clinic/Center
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License Number | 40540
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License Number State | GA
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