Provider Demographics
NPI:1114959319
Name:HIRSH, AMY HARA (MD)
Entity Type:Individual
Prefix:
First Name:AMY
Middle Name:HARA
Last Name:HIRSH
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1800 PEACHTREE ST. NW
Mailing Address - Street 2:SUITE 720
Mailing Address - City:ATLANTA
Mailing Address - State:GA
Mailing Address - Zip Code:30309-2511
Mailing Address - Country:US
Mailing Address - Phone:404-351-7520
Mailing Address - Fax:404-355-2048
Practice Address - Street 1:1800 PEACHTREE ST. NW
Practice Address - Street 2:SUITE 720
Practice Address - City:ATLANTA
Practice Address - State:GA
Practice Address - Zip Code:30309-2511
Practice Address - Country:US
Practice Address - Phone:404-351-7520
Practice Address - Fax:404-355-2048
Is Sole Proprietor?:No
Enumeration Date:2006-07-07
Last Update Date:2012-04-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GA042058207KA0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207KA0200XAllopathic & Osteopathic PhysiciansAllergy & ImmunologyAllergy
Provider Identifiers
StateIdentifier IDID TypeIssuer
GA110235086OtherRAILROAD MEDICARE
102971OtherCOVENTRY
812925OtherBCBS
8789OtherKAISER
GA00894143CMedicaid
159662AAOtherPREFFERED CARE
1352440003OtherCIGNA
AA31903OtherHARVARD PILGRIM HEALTHCAR
812925OtherBCBS
GA03BDB0RMedicare ID - Type Unspecified