Provider Demographics
NPI:1023183530
Name:ATLANTA ORTHOPEDIC SURGERY CONSULTANTS, LLC
Entity Type:Organization
Organization Name:ATLANTA ORTHOPEDIC SURGERY CONSULTANTS, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:RAJU
Authorized Official - Middle Name:M
Authorized Official - Last Name:VANAPALLI
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:770-968-7421
Mailing Address - Street 1:1115 MOUNT ZION RD
Mailing Address - Street 2:SUITE J
Mailing Address - City:MORROW
Mailing Address - State:GA
Mailing Address - Zip Code:30260-2266
Mailing Address - Country:US
Mailing Address - Phone:770-968-7421
Mailing Address - Fax:770-960-0078
Practice Address - Street 1:1115 MOUNT ZION RD
Practice Address - Street 2:SUITE J
Practice Address - City:MORROW
Practice Address - State:GA
Practice Address - Zip Code:30260-2266
Practice Address - Country:US
Practice Address - Phone:770-968-7421
Practice Address - Fax:770-960-0078
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-11-21
Last Update Date:2008-05-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207XS0106XAllopathic & Osteopathic PhysiciansOrthopaedic SurgeryHand SurgeryGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
GA20NCCQNMedicare PIN
GAD31082Medicare UPIN