MEDICARE: NORTH ATLANTA PDOIATRY GRP, PC

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	213E00000X	Podiatrist

Medicare Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
2	CN7503	OTHER	GA	RAILROAD MEDICARE

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	0430650004	OTHER	GA	CIGNA GOVERNMENT SERVICES

General Provider Information

NPI Number	:	1619261989
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	NORTH ATLANTA PDOIATRY GRP, PC

Provider Business Mailing Address
First Line	:	771 OLD NORCROSS RD
Second Line	:	STE 355
City	:	LAWRENCEVILLE
State	:	GA
Zip	:	30046-4386
Country	:	US
Telephone Number	:	770-963-5161
Fax Number	:	678-430-0018

Provider Business Practice Location Address
First Line	:	11459 JOHNS CREEK PKWY
Second Line	:	STE 260
City	:	DULUTH
State	:	GA
Zip	:	30097-3515
Country	:	US
Telephone Number	:	770-963-5161
Fax Number	:	678-430-0018

Authorized Official
Title or Position	:	PARTNER
Name	:	ROBERT I SCHWARTZ
Credential	:
Telephone Number	:	770-963-5161

Provider Enumeration Date	:	06/04/2011
Last Update Date	:	06/04/2011

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Directions to “NORTH ATLANTA PDOIATRY GRP, PC ” Practice Location

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