Provider Demographics
NPI:1437584307
Name:SHEFFRIN MEN'S HEALTH-NW ATL
Entity Type:Organization
Organization Name:SHEFFRIN MEN'S HEALTH-NW ATL
Other - Org Name:SHEFFRIN MEN'S HEALTH
Other - Org Type:Doing Business As
Authorized Official - Title/Position:AGENT
Authorized Official - Prefix:
Authorized Official - First Name:MICHAEL
Authorized Official - Middle Name:
Authorized Official - Last Name:SHEFFRIN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:770-977-1414
Mailing Address - Street 1:1000 JOHNSON FERRY RD
Mailing Address - Street 2:SUITE B155
Mailing Address - City:MARIETTA
Mailing Address - State:GA
Mailing Address - Zip Code:30068-2114
Mailing Address - Country:US
Mailing Address - Phone:770-977-1414
Mailing Address - Fax:888-473-7093
Practice Address - Street 1:1000 JOHNSON FERRY RD
Practice Address - Street 2:SUITE B155
Practice Address - City:MARIETTA
Practice Address - State:GA
Practice Address - Zip Code:30068-2114
Practice Address - Country:US
Practice Address - Phone:770-977-1414
Practice Address - Fax:888-473-7093
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-09-10
Last Update Date:2013-09-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GA055194208D00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208D00000XAllopathic & Osteopathic PhysiciansGeneral PracticeGroup - Single Specialty