Provider Demographics
NPI:1790881456
Name:CARDIOVASCULAR PHYSICIANS OF NORTH ATLANTA, P.C.
Entity Type:Organization
Organization Name:CARDIOVASCULAR PHYSICIANS OF NORTH ATLANTA, P.C.
Other - Org Name:CPNA
Other - Org Type:Other Name
Authorized Official - Title/Position:CFO
Authorized Official - Prefix:MS
Authorized Official - First Name:SUZANNE
Authorized Official - Middle Name:
Authorized Official - Last Name:BALBOA
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:678-242-2020
Mailing Address - Street 1:1285 UPPER HEMBREE RD
Mailing Address - Street 2:
Mailing Address - City:ROSWELL
Mailing Address - State:GA
Mailing Address - Zip Code:30076-1143
Mailing Address - Country:US
Mailing Address - Phone:770-343-8565
Mailing Address - Fax:770-343-8651
Practice Address - Street 1:1285 UPPER HEMBREE RD
Practice Address - Street 2:
Practice Address - City:ROSWELL
Practice Address - State:GA
Practice Address - Zip Code:30076-1143
Practice Address - Country:US
Practice Address - Phone:770-343-8565
Practice Address - Fax:770-343-8651
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-09-16
Last Update Date:2008-09-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207RC0000XAllopathic & Osteopathic PhysiciansInternal MedicineCardiovascular DiseaseGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
GAGRP1985Medicare ID - Type Unspecified