Provider Demographics
NPI:1144407198
Name:CRUZ AGUILAR, CESAR ISAAC (MD)
Entity Type:Individual
Prefix:DR
First Name:CESAR
Middle Name:ISAAC
Last Name:CRUZ AGUILAR
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 1:900 TOWNE LAKE PKWY
Mailing Address - Street 2:STE 400
Mailing Address - City:WOODSTOCK
Mailing Address - State:GA
Mailing Address - Zip Code:30189-1602
Mailing Address - Country:US
Mailing Address - Phone:770-924-5095
Mailing Address - Fax:770-924-7429
Practice Address - Street 1:900 TOWNE LAKE PKWY
Practice Address - Street 2:STE 400
Practice Address - City:WOODSTOCK
Practice Address - State:GA
Practice Address - Zip Code:30189-1602
Practice Address - Country:US
Practice Address - Phone:770-924-5095
Practice Address - Fax:770-924-7429
Is Sole Proprietor?:No
Enumeration Date:2008-01-22
Last Update Date:2020-10-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GA67550207RC0001X, 207RC0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RC0001XAllopathic & Osteopathic PhysiciansInternal MedicineClinical Cardiac Electrophysiology
No207RC0000XAllopathic & Osteopathic PhysiciansInternal MedicineCardiovascular Disease
Provider Identifiers
StateIdentifier IDID TypeIssuer
GA003137201DMedicaid
GA003137201EMedicaid
GA003148597AMedicaid
GA003137201DMedicaid