| NPI | 1417977885 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | DAN CAVALLARO CEO 678-957-8801 |
| Organization Subpart ? | No |
| Primary Taxonomy | 208600000X Surgery (Licence: GA 058760) |
| Additional Taxonomies | 363AS0400X Physician Assistant, Surgical (Licence: GA 003284) |
| 363AS0400X Physician Assistant, Surgical (Licence: GA 004761) | |
| 363AS0400X Physician Assistant, Surgical (Licence: GA 005133) | |
| 363AS0400X Physician Assistant, Surgical (Licence: GA 003653) | |
| 363AS0400X Physician Assistant, Surgical (Licence: GA 003394) | |
| 363AS0400X Physician Assistant, Surgical (Licence: GA 003970) | |
| 208600000X Surgery (Licence: GA 028757) | |
| 208600000X Surgery (Licence: GA 015910) | |
| 363AS0400X Physician Assistant, Surgical (Licence: GA 000870) | |
| 363AS0400X Physician Assistant, Surgical (Licence: GA 004785) | |
| 363AS0400X Physician Assistant, Surgical (Licence: GA 004703) | |
| 363AS0400X Physician Assistant, Surgical (Licence: GA 005631) | |
| Enumeration Date | 2006-07-20 |
| Last Update Date | 2011-06-17 |