| NPI | 1114298775 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ANN H SCHAKER Billing Director 678-983-4479 |
| Organization Subpart ? | Yes |
| Primary Taxonomy | 246ZC0007X Specialist/Technologist, Other, Surgical Assistant |
| Additional Taxonomies | 208600000X Surgery |
| 363AS0400X Physician Assistant, Surgical | |
| Enumeration Date | 2012-01-13 |
| Last Update Date | 2012-01-13 |