Provider Demographics
NPI:1710144019
Name:EMORY UNIVERSITH HOSPITAL
Entity Type:Organization
Organization Name:EMORY UNIVERSITH HOSPITAL
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:INTERVEVTIONAL RAIDIOLOGY DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:ABBAS
Authorized Official - Middle Name:
Authorized Official - Last Name:CHAMSUDDIN
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:404-712-7033
Mailing Address - Street 1:1364 CLIFTON RD NE
Mailing Address - Street 2:INTERVENTIONAL RADIOLOGY
Mailing Address - City:ATLANTA
Mailing Address - State:GA
Mailing Address - Zip Code:30322-1059
Mailing Address - Country:US
Mailing Address - Phone:404-712-7033
Mailing Address - Fax:404-712-7970
Practice Address - Street 1:1364 CLIFTON RD NE
Practice Address - Street 2:INTERVENTIONAL RADIOLOGY
Practice Address - City:ATLANTA
Practice Address - State:GA
Practice Address - Zip Code:30322-1059
Practice Address - Country:US
Practice Address - Phone:404-712-7033
Practice Address - Fax:404-712-7970
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-05-22
Last Update Date:2008-05-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GARN178076 NP282N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes282N00000XHospitalsGeneral Acute Care Hospital