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NPI Code Detail

MEDICARE: MOBILE ANESTHESIA OF GEORGIA LLC

MEDICARE: MOBILE ANESTHESIA OF GEORGIA LLC
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
1207L00000XAnesthesiology Physician039201GA

General Provider Information

NPI Number : 1689957250
Entity Type Code : Organization
Provider Name (Legal Business Name) : MOBILE ANESTHESIA OF GEORGIA LLC
Provider Business Mailing Address
First Line : 6111 PEACHTREE DUNWOODY RD NE
Second Line : BUILDING E, SUITE 101
City : ATLANTA
State : GA
Zip : 30328-6049
Country : US
Telephone Number : 770-552-9236
Fax Number : 770-529-0928
Provider Business Practice Location Address
First Line : 6111 PEACHTREE DUNWOODY RD NE
Second Line : BUILDING E, SUITE 101
City : ATLANTA
State : GA
Zip : 30328-6049
Country : US
Telephone Number : 770-552-9236
Fax Number : 770-529-0928
Authorized Official
Title or Position : PRESIDENT
Name : DR. STANFORD ROSS PLAVIN
Credential : M.D.
Telephone Number : 770-552-9236
Provider Enumeration Date : 09/21/2011
Last Update Date : 09/21/2011

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Directions to “MOBILE ANESTHESIA OF GEORGIA LLC ” Practice Location

Language Start Address Practice Location
These directions are for planning purposes only. You may find that construction projects, traffic, or other events may cause road conditions to differ from the map results.

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