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General NPI Number Information
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NPI Number | 1821214875
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Entity Type | Organization
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Legal Business Name | METRO ATLANTA SURGICAL ASSISTANTS, LLC
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Dates
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Enumeration Date | 04/18/2007
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Last Update Date | 04/02/2014
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Provider Practice Location Address
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Address Line | 3705 NEW MACLAND RD STE. 200-114
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City | POWDER SPRINGS
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State | GA
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Zip | 30127-1966
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Country | US
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Telephone | 404-918-3670
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Fax | 770-439-2058
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Provider Business Mailing Address
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Address Line | 3705 NEW MACLAND RD STE. 200-114
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City | POWDER SPRINGS
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State | GA
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Zip | 30127-1966
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Country | US
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Telephone | 404-918-3670
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Fax | 770-439-2058
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Authorized Official
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Title or Position | OWNER
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Name | TORRA ELDER
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Credential |
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Telephone | 404-918-3670
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 363A00000X
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Taxonomy Name | Physician Assistant
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License Number | 3553
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License Number State | GA
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