Provider Demographics
NPI:1306035126
Name:MARTHA A SCHUH, MD
Entity Type:Organization
Organization Name:MARTHA A SCHUH, MD
Other - Org Name:PEACHTREE IMMEDIATE CARE AND OCCUPATIONAL MEDICINE
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER / PHYSICIAN
Authorized Official - Prefix:DR
Authorized Official - First Name:MARTHA
Authorized Official - Middle Name:ANN
Authorized Official - Last Name:SCHUH
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:770-461-3776
Mailing Address - Street 1:1275 HIGHWAY 54 W
Mailing Address - Street 2:SUITE 201
Mailing Address - City:FAYETTEVILLE
Mailing Address - State:GA
Mailing Address - Zip Code:30214-4549
Mailing Address - Country:US
Mailing Address - Phone:770-461-3776
Mailing Address - Fax:770-461-3565
Practice Address - Street 1:1275 HIGHWAY 54 W
Practice Address - Street 2:SUITE 201
Practice Address - City:FAYETTEVILLE
Practice Address - State:GA
Practice Address - Zip Code:30214-4549
Practice Address - Country:US
Practice Address - Phone:770-461-3776
Practice Address - Fax:770-461-3565
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-10-17
Last Update Date:2010-03-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GAGA 037488174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes174400000XOther Service ProvidersSpecialistGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
GAGRP6279OtherMEDICARE GROUP
GAGRP6279OtherMEDICARE GROUP
GAF72180Medicare UPIN