Provider Demographics
NPI:1295003531
Name:ATLANTA VASCULAR RESEARCH FOUNDATION
Entity Type:Organization
Organization Name:ATLANTA VASCULAR RESEARCH FOUNDATION
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR OF CLINICAL OPERATIONS
Authorized Official - Prefix:DR
Authorized Official - First Name:NADYA
Authorized Official - Middle Name:
Authorized Official - Last Name:MERCHANT
Authorized Official - Suffix:
Authorized Official - Credentials:PHD
Authorized Official - Phone:770-621-9656
Mailing Address - Street 1:3562 HABERSHAM AT NORTHLAKE
Mailing Address - Street 2:BUILDING J
Mailing Address - City:TUCKER
Mailing Address - State:GA
Mailing Address - Zip Code:30084-4010
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:3562 HABERSHAM AT NORTHLAKE
Practice Address - Street 2:BUILDING J
Practice Address - City:TUCKER
Practice Address - State:GA
Practice Address - Zip Code:30084-4010
Practice Address - Country:US
Practice Address - Phone:770-621-9656
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-12-01
Last Update Date:2011-12-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1744R1102XOther Service ProvidersSpecialistResearch StudyGroup - Multi-Specialty