Provider Demographics
NPI:1164503132
Name:ATLANTA NEUROSURGICAL ASSOCIATES, P.A.
Entity Type:Organization
Organization Name:ATLANTA NEUROSURGICAL ASSOCIATES, P.A.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:MICHAEL
Authorized Official - Middle Name:G
Authorized Official - Last Name:HARTMAN
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:404-292-4612
Mailing Address - Street 1:2785 LAWRENCEVILLE HWY
Mailing Address - Street 2:SUITE 100
Mailing Address - City:DECATUR
Mailing Address - State:GA
Mailing Address - Zip Code:30033-2515
Mailing Address - Country:US
Mailing Address - Phone:404-292-4612
Mailing Address - Fax:678-514-0088
Practice Address - Street 1:2785 LAWRENCEVILLE HWY
Practice Address - Street 2:SUITE 100
Practice Address - City:DECATUR
Practice Address - State:GA
Practice Address - Zip Code:30033-2515
Practice Address - Country:US
Practice Address - Phone:404-292-4612
Practice Address - Fax:678-514-0088
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-10-18
Last Update Date:2010-02-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207T00000XAllopathic & Osteopathic PhysiciansNeurological SurgeryGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
GAGRP1149Medicare ID - Type Unspecified