Provider Demographics
NPI:1144202516
Name:CHALIFF, MICHAEL (MD)
Entity Type:Individual
Prefix:DR
First Name:MICHAEL
Middle Name:
Last Name:CHALIFF
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6000 LAKE FORREST DR NW
Mailing Address - Street 2:SUITE 475
Mailing Address - City:ATLANTA
Mailing Address - State:GA
Mailing Address - Zip Code:30328-3824
Mailing Address - Country:US
Mailing Address - Phone:404-459-8440
Mailing Address - Fax:
Practice Address - Street 1:6000 LAKE FORREST DR NW
Practice Address - Street 2:SUITE 475
Practice Address - City:ATLANTA
Practice Address - State:GA
Practice Address - Zip Code:30328-3824
Practice Address - Country:US
Practice Address - Phone:404-459-8440
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2005-11-18
Last Update Date:2011-07-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GA298542085R0202X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2085R0202XAllopathic & Osteopathic PhysiciansRadiologyDiagnostic Radiology
Provider Identifiers
StateIdentifier IDID TypeIssuer
GA000360456GMedicaid
GA30BDFVMMedicare PIN
GA000360456GMedicaid