Provider Demographics
NPI:1679510044
Name:NORTH FULTON EAR NOSE AND THROAT ASSOCIATES, P.C.
Entity Type:Organization
Organization Name:NORTH FULTON EAR NOSE AND THROAT ASSOCIATES, P.C.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CFO
Authorized Official - Prefix:DR
Authorized Official - First Name:RAYMOND
Authorized Official - Middle Name:L
Authorized Official - Last Name:SCHETTINO
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:770-343-8675
Mailing Address - Street 1:2500 HOSPITAL BLVD
Mailing Address - Street 2:SUITE 450
Mailing Address - City:ROSWELL
Mailing Address - State:GA
Mailing Address - Zip Code:30076-4907
Mailing Address - Country:US
Mailing Address - Phone:770-343-8675
Mailing Address - Fax:770-343-8773
Practice Address - Street 1:2500 HOSPITAL BLVD
Practice Address - Street 2:SUITE 450
Practice Address - City:ROSWELL
Practice Address - State:GA
Practice Address - Zip Code:30076-4907
Practice Address - Country:US
Practice Address - Phone:770-343-8675
Practice Address - Fax:770-343-8773
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-06-02
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes174400000XOther Service ProvidersSpecialistGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
GA00408548AMedicaid
GA00428293AMedicaid
GA00580104FMedicaid
GA00749229HMedicaid
GA00408548AMedicaid
GA00428293AMedicaid
GAF26148Medicare UPIN
GA04BDBDHMedicare ID - Type UnspecifiedDR. RAYMOND SCHETTINO
GA04BDBKTMedicare ID - Type UnspecifiedDR.JOEL HOFFMAN
GAC48969Medicare UPIN
GA04BDBCJMedicare ID - Type UnspecifiedDR. ROY SCHOTTENFELD
GA04BDBSHMedicare ID - Type UnspecifiedDR.MARK YANTA