Provider Demographics
NPI:1225314982
Name:NEUROLOGY ASSOCIATES, P.C.
Entity Type:Organization
Organization Name:NEUROLOGY ASSOCIATES, P.C.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER OPERATOR
Authorized Official - Prefix:DR
Authorized Official - First Name:VIRENDRA
Authorized Official - Middle Name:V
Authorized Official - Last Name:RANADIVE
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:770-716-1562
Mailing Address - Street 1:115 SUMNER RD FL 2
Mailing Address - Street 2:
Mailing Address - City:FAYETTEVILLE
Mailing Address - State:GA
Mailing Address - Zip Code:30214-4758
Mailing Address - Country:US
Mailing Address - Phone:770-716-1562
Mailing Address - Fax:770-716-0145
Practice Address - Street 1:1250 HIGHWAY 54 WEST
Practice Address - Street 2:SUITE 201
Practice Address - City:FAYETTEVILLE
Practice Address - State:GA
Practice Address - Zip Code:30214
Practice Address - Country:US
Practice Address - Phone:770-716-1562
Practice Address - Fax:770-716-0145
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-10-26
Last Update Date:2018-03-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GA047510174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes174400000XOther Service ProvidersSpecialistGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
H44492Medicare UPIN