Provider Demographics
NPI:1417915992
Name:PELTA, ARIE E (MD)
Entity Type:Individual
Prefix:DR
First Name:ARIE
Middle Name:E
Last Name:PELTA
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
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Other - Credentials:
Mailing Address - Street 1:315 BOULEVARD NE
Mailing Address - Street 2:SUITE# 500
Mailing Address - City:ATLANTA
Mailing Address - State:GA
Mailing Address - Zip Code:30312-1266
Mailing Address - Country:US
Mailing Address - Phone:404-265-3635
Mailing Address - Fax:404-265-3635
Practice Address - Street 1:315 BOULEVARD NE
Practice Address - Street 2:SUITE# 500
Practice Address - City:ATLANTA
Practice Address - State:GA
Practice Address - Zip Code:30312-1266
Practice Address - Country:US
Practice Address - Phone:404-265-3635
Practice Address - Fax:404-265-3635
Is Sole Proprietor?:No
Enumeration Date:2006-05-03
Last Update Date:2011-11-22
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
GA057416208C00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208C00000XAllopathic & Osteopathic PhysiciansColon & Rectal Surgery