MEDICARE: PETER ASH MD

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	2084P0800X	Psychiatry Physician	036678	GA

General Provider Information

NPI Number	:	1053379669
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	PETER ASH MD

Provider Business Mailing Address
First Line	:	12 EXECUTIVE PARK DR NE
Second Line	:	CHILD PSYCHIATRY, SUITE 200
City	:	ATLANTA
State	:	GA
Zip	:	30329-2206
Country	:	US
Telephone Number	:	404-727-3973
Fax Number	:	404-727-3155

Provider Business Practice Location Address
First Line	:	12 EXECUTIVE PARK DR NE
Second Line	:	CHILD PSYCHIATRY, SUITE 200
City	:	ATLANTA
State	:	GA
Zip	:	30329-2206
Country	:	US
Telephone Number	:	404-727-3973
Fax Number	:	404-727-3155

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	05/03/2006
Last Update Date	:	04/15/2017

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