=====================================================
General NPI Number Information
=====================================================
NPI Number | 1598941320
-----------------------------------------------------
Entity Type | Organization
-----------------------------------------------------
Legal Business Name | EMORY UNIVERSITY
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 01/10/2008
-----------------------------------------------------
Last Update Date | 01/10/2008
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 3200 LENOX RD NE E212
-----------------------------------------------------
City | ATLANTA
-----------------------------------------------------
State | GA
-----------------------------------------------------
Zip | 30324-2679
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 404-512-7827
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 3200 LENOX RD NE E212
-----------------------------------------------------
City | ATLANTA
-----------------------------------------------------
State | GA
-----------------------------------------------------
Zip | 30324-2679
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone |
-----------------------------------------------------
Fax |
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position | ASSOCIATE DEAN FOR GRADUATE MEDICAL
-----------------------------------------------------
Name | DR. JAMES R. ZAIDAN
-----------------------------------------------------
Credential |
-----------------------------------------------------
Telephone | 404-778-3903
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 282N00000X
-----------------------------------------------------
Taxonomy Name | General Acute Care Hospital
-----------------------------------------------------
License Number | 59897
-----------------------------------------------------
License Number State | GA
-----------------------------------------------------