Provider Demographics
NPI:1659755692
Name:THE SPINE INSTITUTE OF PEACHTREE NEUROSURGERY, LLC
Entity Type:Organization
Organization Name:THE SPINE INSTITUTE OF PEACHTREE NEUROSURGERY, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/MD
Authorized Official - Prefix:MS
Authorized Official - First Name:MAX
Authorized Official - Middle Name:
Authorized Official - Last Name:STEUER
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:608-957-3025
Mailing Address - Street 1:1150 HAMMOND DR STE E600
Mailing Address - Street 2:
Mailing Address - City:ATLANTA
Mailing Address - State:GA
Mailing Address - Zip Code:30328-8604
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:1150 HAMMOND DR STE E600
Practice Address - Street 2:
Practice Address - City:ATLANTA
Practice Address - State:GA
Practice Address - Zip Code:30328-8604
Practice Address - Country:US
Practice Address - Phone:404-256-2633
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-07-18
Last Update Date:2022-03-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QA1903XAmbulatory Health Care FacilitiesClinic/CenterAmbulatory Surgical