Provider Demographics
NPI:1467699611
Name:FUSION SLEEP MEDICAL LLC
Entity Type:Organization
Organization Name:FUSION SLEEP MEDICAL LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:MR
Authorized Official - First Name:SIGURJON
Authorized Official - Middle Name:
Authorized Official - Last Name:KRISTJANSSON
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:678-990-3962
Mailing Address - Street 1:4245 JOHNS CREEK PKWY STE A
Mailing Address - Street 2:
Mailing Address - City:SUWANEE
Mailing Address - State:GA
Mailing Address - Zip Code:30024-9122
Mailing Address - Country:US
Mailing Address - Phone:678-990-3962
Mailing Address - Fax:678-623-3862
Practice Address - Street 1:4245 JOHNS CREEK PKWY STE A
Practice Address - Street 2:
Practice Address - City:SUWANEE
Practice Address - State:GA
Practice Address - Zip Code:30024-9122
Practice Address - Country:US
Practice Address - Phone:678-990-3962
Practice Address - Fax:678-623-3862
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-01-09
Last Update Date:2024-01-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes261QS1200XAmbulatory Health Care FacilitiesClinic/CenterSleep Disorder Diagnostic
No174400000XOther Service ProvidersSpecialistGroup - Multi-Specialty
No207RS0012XAllopathic & Osteopathic PhysiciansInternal MedicineSleep MedicineGroup - Multi-Specialty
No207Y00000XAllopathic & Osteopathic PhysiciansOtolaryngologyGroup - Multi-Specialty
No207YS0012XAllopathic & Osteopathic PhysiciansOtolaryngologySleep MedicineGroup - Multi-Specialty
No2080S0012XAllopathic & Osteopathic PhysiciansPediatricsSleep MedicineGroup - Multi-Specialty
No2084S0012XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologySleep MedicineGroup - Multi-Specialty
No261QM1300XAmbulatory Health Care FacilitiesClinic/CenterMulti-Specialty
No332B00000XSuppliersDurable Medical Equipment & Medical SuppliesGroup - Multi-Specialty