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General NPI Number Information
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NPI Number | 1700951563
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Entity Type | Organization
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Legal Business Name | GEORGIA HEART ASSOCIATES, PC
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Dates
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Enumeration Date | 11/21/2006
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Last Update Date | 08/30/2011
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Provider Practice Location Address
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Address Line | 33 UPPER RIVERDALE RD SW SUITE 118
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City | RIVERDALE
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State | GA
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Zip | 30274-2626
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Country | US
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Telephone | 770-991-9166
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Fax | 770-991-9890
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Provider Business Mailing Address
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Address Line | 33 UPPER RIVERDALE ROAD SUITE 118
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City | RIVERDALE
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State | GA
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Zip | 30274
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Country | US
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Telephone | 770-991-9166
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Fax | 770-991-9890
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Authorized Official
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Title or Position | OWNER OF PRACTICE
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Name | DR. STEVEN ROSENTHAL
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Credential | MD
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Telephone | 770-991-9166
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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 | 036445
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License Number State | GA
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