MEDICARE: SYNERGY MEDICAL CENTERS OF ATLANTA

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	174400000X	Specialist

General Provider Information

NPI Number	:	1487833612
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	SYNERGY MEDICAL CENTERS OF ATLANTA

Provider Business Mailing Address
First Line	:	240 N HIGHLAND AVE NE
Second Line	:	SUITE F
City	:	ATLANTA
State	:	GA
Zip	:	30307-5609
Country	:	US
Telephone Number	:	404-588-0804
Fax Number	:	404-588-0807

Provider Business Practice Location Address
First Line	:	240 N HIGHLAND AVE NE
Second Line	:	SUITE F
City	:	ATLANTA
State	:	GA
Zip	:	30307-5609
Country	:	US
Telephone Number	:	404-588-0804
Fax Number	:	404-588-0807

Authorized Official
Title or Position	:	OWNER
Name	:	FRANCIS JOSEPH MARCONE
Credential	:
Telephone Number	:	646-705-1547

Provider Enumeration Date	:	10/24/2007
Last Update Date	:	11/02/2011

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