Provider Demographics
NPI:1598872434
Name:NORTH ATLANTA KIDNEY SPECIALISTS
Entity Type:Organization
Organization Name:NORTH ATLANTA KIDNEY SPECIALISTS
Other - Org Name:STUART HANDELSMAN, M.D.P.C.
Other - Org Type:Former Legal Business Name
Authorized Official - Title/Position:OFFICE MANAGER
Authorized Official - Prefix:MRS
Authorized Official - First Name:MARIAN
Authorized Official - Middle Name:ANDREA
Authorized Official - Last Name:JORDAN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:404-252-0256
Mailing Address - Street 1:980 JOHNSON FERRY RD NE
Mailing Address - Street 2:SUITE 410
Mailing Address - City:ATLANTA
Mailing Address - State:GA
Mailing Address - Zip Code:30342-1626
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:980 JOHNSON FERRY RD NE
Practice Address - Street 2:SUITE 410
Practice Address - City:ATLANTA
Practice Address - State:GA
Practice Address - Zip Code:30342-1626
Practice Address - Country:US
Practice Address - Phone:404-252-0256
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-08-24
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GA02152207RN0300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207RN0300XAllopathic & Osteopathic PhysiciansInternal MedicineNephrologyGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
GAD29678Medicare UPIN
GAI30630Medicare UPIN