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NPI Code Detail

MEDICARE: ARTURO EDUARDO REYES BANOS PA

MEDICARE: ARTURO EDUARDO REYES BANOS PA
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
1363A00000XPhysician Assistant12499GA

General Provider Information

NPI Number : 1437993904
Entity Type Code : Individual
Provider Name (Legal Business Name) : ARTURO EDUARDO REYES BANOS PA
Provider Business Mailing Address
First Line : 4850 SUGARLOAF PKWY STE 501
Second Line :
City : LAWRENCEVILLE
State : GA
Zip : 30044-2864
Country : US
Telephone Number : 770-962-1616
Fax Number : 770-962-7977
Provider Business Practice Location Address
First Line : 4850 SUGARLOAF PKWY STE 501
Second Line :
City : LAWRENCEVILLE
State : GA
Zip : 30044-2864
Country : US
Telephone Number : 770-962-1616
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 06/20/2024
Last Update Date : 08/02/2024

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Directions to “ ARTURO EDUARDO REYES BANOS PA” Practice Location

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