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General NPI Number Information
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NPI Number | 1831236728
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Entity Type | Organization
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Legal Business Name | INFECTIOUS DISEASE SERVICES OF GEORGIA PC
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Dates
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Enumeration Date | 01/31/2007
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Last Update Date | 06/09/2024
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Provider Practice Location Address
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Address Line | 11660 ALPHARETTA HWY SUITE 430
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City | ROSWELL
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State | GA
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Zip | 30076-4943
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Country | US
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Telephone | 770-255-1069
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Fax | 770-255-1075
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Provider Business Mailing Address
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Address Line | 11660 ALPHARETTA HWY SUITE 430
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City | ROSWELL
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State | GA
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Zip | 30076-4943
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Country | US
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Telephone | 770-255-1069
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Fax | 770-255-1075
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Authorized Official
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Title or Position | BILLING DEPARTMENT
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Name | MS. EMILY CHISM
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Credential |
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Telephone | 770-255-1069
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207RI0200X
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Taxonomy Name | Infectious Disease Physician
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License Number |
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License Number State |
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