MEDICARE: SHELDON MICHAEL LINCENBERG MD

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	032233	GA

General Provider Information

NPI Number	:	1598875015
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	SHELDON MICHAEL LINCENBERG MD

Provider Business Mailing Address
First Line	:	1 GLENLAKE PKWY NE
Second Line	:	SUITE 950
City	:	ATLANTA
State	:	GA
Zip	:	30328-3448
Country	:	US
Telephone Number	:	770-730-8222
Fax Number	:	678-527-1281

Provider Business Practice Location Address
First Line	:	1 GLENLAKE PKWY NE
Second Line	:	SUITE 950
City	:	ATLANTA
State	:	GA
Zip	:	30328-3448
Country	:	US
Telephone Number	:	770-730-8222
Fax Number	:	678-527-1281

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

Provider Enumeration Date	:	08/30/2006
Last Update Date	:	10/01/2014

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