Provider Demographics
NPI:1679833420
Name:NORTH FULTON HOSPITALIST GROUP, LLC
Entity Type:Organization
Organization Name:NORTH FULTON HOSPITALIST GROUP, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:SVP REGIONAL OPERATIONS, TENET
Authorized Official - Prefix:MR
Authorized Official - First Name:MICHAEL
Authorized Official - Middle Name:
Authorized Official - Last Name:GRAUE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:469-893-6193
Mailing Address - Street 1:PO BOX 742206
Mailing Address - Street 2:
Mailing Address - City:ATLANTA
Mailing Address - State:GA
Mailing Address - Zip Code:30374-2102
Mailing Address - Country:US
Mailing Address - Phone:770-751-2777
Mailing Address - Fax:770-751-2773
Practice Address - Street 1:3000 HOSPITAL BLVD
Practice Address - Street 2:
Practice Address - City:ROSWELL
Practice Address - State:GA
Practice Address - Zip Code:30076-4915
Practice Address - Country:US
Practice Address - Phone:770-751-2777
Practice Address - Fax:770-751-2773
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-05-25
Last Update Date:2016-05-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal MedicineGroup - Single Specialty