Provider Demographics
NPI:1437275534
Name:ALPHARETTA MEDICAL ASSOCIATES, PC
Entity Type:Organization
Organization Name:ALPHARETTA MEDICAL ASSOCIATES, PC
Other - Org Name:EINSTEIN GENIUS CARE
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PHYSICIAN OWNER
Authorized Official - Prefix:
Authorized Official - First Name:ALAN
Authorized Official - Middle Name:DAVID
Authorized Official - Last Name:EINSTEIN
Authorized Official - Suffix:
Authorized Official - Credentials:DO
Authorized Official - Phone:678-513-2228
Mailing Address - Street 1:3333 OLD MILTON PKWY STE 170
Mailing Address - Street 2:
Mailing Address - City:ALPHARETTA
Mailing Address - State:GA
Mailing Address - Zip Code:30005-0008
Mailing Address - Country:US
Mailing Address - Phone:678-575-5129
Mailing Address - Fax:678-513-1147
Practice Address - Street 1:3333 OLD MILTON PKWY STE 170
Practice Address - Street 2:
Practice Address - City:ALPHARETTA
Practice Address - State:GA
Practice Address - Zip Code:30005-0008
Practice Address - Country:US
Practice Address - Phone:678-513-2228
Practice Address - Fax:678-513-1147
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-03-21
Last Update Date:2023-03-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GAGA 040900207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal MedicineGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
GA00737338BMedicaid
GA 040900OtherGA LICENSE
FLOS 6892OtherFLORIDA LICENSE
GABE 4502375OtherDEA
FLOS 6892OtherFLORIDA LICENSE
FLOS 6892OtherFLORIDA LICENSE