Provider Demographics
NPI:1235141185
Name:CEDAR SURGICAL ASSOCIATES, PC
Entity Type:Organization
Organization Name:CEDAR SURGICAL ASSOCIATES, PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:AKRAM
Authorized Official - Middle Name:MAHMOUD
Authorized Official - Last Name:HASSANYEH
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:912-871-7100
Mailing Address - Street 1:1058 BERMUDA RUN
Mailing Address - Street 2:
Mailing Address - City:STATESBORO
Mailing Address - State:GA
Mailing Address - Zip Code:30458-0858
Mailing Address - Country:US
Mailing Address - Phone:912-871-7100
Mailing Address - Fax:912-871-7110
Practice Address - Street 1:1058 BERMUDA RUN
Practice Address - Street 2:
Practice Address - City:STATESBORO
Practice Address - State:GA
Practice Address - Zip Code:30458-0858
Practice Address - Country:US
Practice Address - Phone:912-871-7100
Practice Address - Fax:912-871-7110
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-08-12
Last Update Date:2010-03-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes174400000XOther Service ProvidersSpecialistGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
GA020046873OtherMEDICARE - RAILROAD - AKR
GA00827681BMedicaid
GA000365131DMedicaid
GA02BBCMJMedicare ID - Type UnspecifiedCAMILLE ATALLAH
GAH01071Medicare UPIN
GA00827681BMedicaid
GA020046873OtherMEDICARE - RAILROAD - AKR
GA042703348AMedicare ID - Type UnspecifiedAKRAM HASSANYEH