Provider Demographics
NPI:1548213218
Name:THE SLEEP DISORDERS CENTER OF CDS
Entity Type:Organization
Organization Name:THE SLEEP DISORDERS CENTER OF CDS
Other - Org Name:CARDIAC DISEASE SPECIALISTS, PC
Other - Org Type:Doing Business As
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:DENNIS
Authorized Official - Middle Name:
Authorized Official - Last Name:BRESLIN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:404-355-9815
Mailing Address - Street 1:275 COLLIER RD NW
Mailing Address - Street 2:STE 300
Mailing Address - City:ATLANTA
Mailing Address - State:GA
Mailing Address - Zip Code:30309-1704
Mailing Address - Country:US
Mailing Address - Phone:404-355-9815
Mailing Address - Fax:404-603-7222
Practice Address - Street 1:1900 THE EXCHANGE SE
Practice Address - Street 2:BLDG 100 STE 100
Practice Address - City:ATLANTA
Practice Address - State:GA
Practice Address - Zip Code:30339-2022
Practice Address - Country:US
Practice Address - Phone:770-984-0201
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-05-17
Last Update Date:2007-11-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GA99999207RS0012X, 332B00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207RS0012XAllopathic & Osteopathic PhysiciansInternal MedicineSleep MedicineGroup - Multi-Specialty
No332B00000XSuppliersDurable Medical Equipment & Medical SuppliesGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
GAGRP595Medicare ID - Type Unspecified