MEDICARE: MICHAEL CHERIYAMPURATHU AUGUSTINE NP

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	363LA2100X	Acute Care Nurse Practitioner	RN316226	GA

General Provider Information

NPI Number	:	1538886916
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MICHAEL CHERIYAMPURATHU AUGUSTINE NP

Provider Business Mailing Address
First Line	:	460 NORTHSIDE CHEROKEE BLVD STE 140
Second Line	:
City	:	CANTON
State	:	GA
Zip	:	30115-8022
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	EMORY UNIVESITY HOSPITAL 1364 CLIFTON RD NE
Second Line	:
City	:	ATLANTA
State	:	GA
Zip	:	30322-8017
Country	:	US
Telephone Number	:	404-712-6834
Fax Number	:

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

Provider Enumeration Date	:	10/26/2022
Last Update Date	:	10/14/2025

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