MEDICARE: COMPREHENSIVE ORTHOPAEDIC GROUP

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	207X00000X	Orthopaedic Surgery Physician

General Provider Information

NPI Number	:	1548252042
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	COMPREHENSIVE ORTHOPAEDIC GROUP

Provider Business Mailing Address
First Line	:	1100 NORTHSIDE FORSYTH DR
Second Line	:	SUITE 400
City	:	CUMMING
State	:	GA
Zip	:	30041-6012
Country	:	US
Telephone Number	:	770-888-1976
Fax Number	:	770-888-8368

Provider Business Practice Location Address
First Line	:	1100 NORTHSIDE FORSYTH DR
Second Line	:	SUITE 400
City	:	CUMMING
State	:	GA
Zip	:	30041-6012
Country	:	US
Telephone Number	:	770-888-1976
Fax Number	:	770-888-8368

Authorized Official
Title or Position	:	BUSINESS OFFICE MANAGER
Name	:	PAM ZUBER
Credential	:
Telephone Number	:	770-888-1976

Provider Enumeration Date	:	08/19/2005
Last Update Date	:	08/22/2020

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