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NPI Code Detail

MEDICARE: ATLANTA HEART SPECIALISTS LLC

MEDICARE: ATLANTA HEART SPECIALISTS 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
1207RI0011XInterventional Cardiology Physician
2207R00000XInternal Medicine Physician
3207RC0001XClinical Cardiac Electrophysiology Physician
4207RC0000XCardiovascular Disease Physician

General Provider Information

NPI Number : 1891881827
Entity Type Code : Organization
Provider Name (Legal Business Name) : ATLANTA HEART SPECIALISTS LLC
Provider Business Mailing Address
First Line : 1468 MONTREAL RD
Second Line :
City : TUCKER
State : GA
Zip : 30084-6901
Country : US
Telephone Number : 770-638-1400
Fax Number : 770-638-1411
Provider Business Practice Location Address
First Line : 1468 MONTREAL RD
Second Line :
City : TUCKER
State : GA
Zip : 30084-6901
Country : US
Telephone Number : 770-638-1400
Fax Number : 770-638-1411
Authorized Official
Title or Position : OWNER
Name : DAVID SONG
Credential : MD
Telephone Number : 770-638-1400
Provider Enumeration Date : 10/05/2006
Last Update Date : 09/08/2014

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Directions to “ATLANTA HEART SPECIALISTS LLC ” Practice Location

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