MEDICARE: BRUCE ANDREW SALZBERG 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	207RG0100X	Gastroenterology Physician	29775	GA

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	581077643	OTHER	GA	TAX ID
2	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1376528943
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	BRUCE ANDREW SALZBERG MD

Provider Business Mailing Address
First Line	:	4395 JOHNS CREEK PKWY
Second Line	:	SUITE 130
City	:	SUWANEE
State	:	GA
Zip	:	30024-6048
Country	:	US
Telephone Number	:	678-957-0057
Fax Number	:	678-957-0047

Provider Business Practice Location Address
First Line	:	4395 JOHNS CREEK PKWY
Second Line	:	SUITE 130
City	:	SUWANEE
State	:	GA
Zip	:	30024-6048
Country	:	US
Telephone Number	:	678-957-0057
Fax Number	:	678-957-0047

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

Provider Enumeration Date	:	12/07/2005
Last Update Date	:	10/06/2014

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Directions to “ BRUCE ANDREW SALZBERG MD” Practice Location

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