| NPI | 1194079939 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | SHELDON B EBERHART Operations Manager 404-548-9099 |
| Organization Subpart ? | No |
| Primary Taxonomy | 305R00000X Preferred Provider Organization (Licence: GA ga67890) |
| Enumeration Date | 2012-11-01 |
| Last Update Date | 2012-11-01 |