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General NPI Number Information
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NPI Number | 1831553163
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Entity Type | Organization
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Legal Business Name | CENTRESPRING MD
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Dates
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Enumeration Date | 04/13/2016
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Last Update Date | 04/13/2016
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Provider Practice Location Address
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Address Line | 1401 DRESDEN DR NE
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City | BROOKHAVEN
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State | GA
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Zip | 30319-3579
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Country | US
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Telephone | 404-814-9808
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Fax | 404-814-6086
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Provider Business Mailing Address
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Address Line | 1401 DRESDEN DR NE
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City | BROOKHAVEN
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State | GA
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Zip | 30319-3579
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Country | US
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Telephone | 404-814-9808
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Fax | 404-814-6086
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Authorized Official
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Title or Position | FOUNDER
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Name | TASNEEM BHATIA
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Credential | MD
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Telephone | 404-814-9808
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QP2300X
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Taxonomy Name | Primary Care Clinic/Center
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License Number |
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License Number State |
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