Provider Demographics
NPI:1770182586
Name:NUBERTY INC
Entity Type:Organization
Organization Name:NUBERTY INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:DESMOND
Authorized Official - Middle Name:
Authorized Official - Last Name:MASON
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:404-807-4147
Mailing Address - Street 1:227 SANDY SPRINGS PL STE 220
Mailing Address - Street 2:
Mailing Address - City:SANDY SPRINGS
Mailing Address - State:GA
Mailing Address - Zip Code:30328-5935
Mailing Address - Country:US
Mailing Address - Phone:404-480-5229
Mailing Address - Fax:
Practice Address - Street 1:227 SANDY SPRINGS PL STE 220
Practice Address - Street 2:
Practice Address - City:SANDY SPRINGS
Practice Address - State:GA
Practice Address - Zip Code:30328-5935
Practice Address - Country:US
Practice Address - Phone:404-480-5229
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-10-22
Last Update Date:2020-10-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal MedicineGroup - Multi-Specialty