Provider Demographics
NPI:1417232927
Name:SEQUENTIAL MANAGEMENT GROUP INC
Entity Type:Organization
Organization Name:SEQUENTIAL MANAGEMENT GROUP INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR
Authorized Official - Prefix:MR
Authorized Official - First Name:SEAN
Authorized Official - Middle Name:MICHAEL
Authorized Official - Last Name:GARY
Authorized Official - Suffix:
Authorized Official - Credentials:MPA/CWP
Authorized Official - Phone:866-563-5557
Mailing Address - Street 1:3040 PHARR COURT NORTH NW STE 5
Mailing Address - Street 2:
Mailing Address - City:ATLANTA
Mailing Address - State:GA
Mailing Address - Zip Code:30305
Mailing Address - Country:US
Mailing Address - Phone:866-563-5557
Mailing Address - Fax:800-665-6727
Practice Address - Street 1:3040 PHARR COURT NORTH NW STE 5
Practice Address - Street 2:
Practice Address - City:ATLANTA
Practice Address - State:GA
Practice Address - Zip Code:30305
Practice Address - Country:US
Practice Address - Phone:866-563-5557
Practice Address - Fax:800-665-6727
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-10-15
Last Update Date:2021-09-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GA0569745291U00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes291U00000XLaboratoriesClinical Medical Laboratory