Provider Demographics
NPI:1164434247
Name:NORTH ATLANTA MEDICAL ASSOCIATES, PC
Entity Type:Organization
Organization Name:NORTH ATLANTA MEDICAL ASSOCIATES, PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PARTNER
Authorized Official - Prefix:MR
Authorized Official - First Name:ARTHUR
Authorized Official - Middle Name:J
Authorized Official - Last Name:GREEN
Authorized Official - Suffix:
Authorized Official - Credentials:DO
Authorized Official - Phone:770-934-7876
Mailing Address - Street 1:2545 LAWRENCEVILLE HWY
Mailing Address - Street 2:SUITE 200
Mailing Address - City:DECATUR
Mailing Address - State:GA
Mailing Address - Zip Code:30033-3240
Mailing Address - Country:US
Mailing Address - Phone:770-934-7876
Mailing Address - Fax:678-990-7236
Practice Address - Street 1:2545 LAWRENCEVILLE HWY
Practice Address - Street 2:SUITE 200
Practice Address - City:DECATUR
Practice Address - State:GA
Practice Address - Zip Code:30033-3240
Practice Address - Country:US
Practice Address - Phone:770-934-7876
Practice Address - Fax:678-990-7236
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-08-13
Last Update Date:2010-04-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal MedicineGroup - Single Specialty
No207Q00000XAllopathic & Osteopathic PhysiciansFamily MedicineGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
GAGRP1052Medicare ID - Type Unspecified