| NPI | 1689966533 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ANN SCHAKER Billing Director 678-983-4479 |
| Organization Subpart ? | No |
| Primary Taxonomy | 363AS0400X Physician Assistant, Surgical |
| Additional Taxonomies | 246ZC0007X Specialist/Technologist, Other, Surgical Assistant |
| Enumeration Date | 2011-05-11 |
| Last Update Date | 2011-08-16 |