MEDICARE: IDEAL GYNECOLOGY

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	261Q00000X	Clinic/Center	40540	GA

General Provider Information

NPI Number	:	1508222423
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	IDEAL GYNECOLOGY

Provider Business Mailing Address
First Line	:	3200 DOWNWOOD CIR NW STE 220
Second Line	:
City	:	ATLANTA
State	:	GA
Zip	:	30327-1611
Country	:	US
Telephone Number	:	470-312-3696
Fax Number	:

Provider Business Practice Location Address
First Line	:	3200 DOWNWOOD CIR NW STE 220
Second Line	:
City	:	ATLANTA
State	:	GA
Zip	:	30327-1611
Country	:	US
Telephone Number	:	470-312-3696
Fax Number	:

Authorized Official
Title or Position	:	OWNER
Name	:	DR. LILLIAN SCHAPIRO
Credential	:	M.D.
Telephone Number	:	404-550-4503

Provider Enumeration Date	:	01/07/2016
Last Update Date	:	02/01/2017

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Directions to “IDEAL GYNECOLOGY ” Practice Location

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