Provider Demographics
NPI:1891770327
Name:HOLLANDER, SUSAN (PA-C)
Entity Type:Individual
Prefix:
First Name:SUSAN
Middle Name:
Last Name:HOLLANDER
Suffix:
Gender:F
Credentials:PA-C
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Other - First Name:
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Mailing Address - Street 1:550 PEACHTREE ST NE
Mailing Address - Street 2:SUITE 1620
Mailing Address - City:ATLANTA
Mailing Address - State:GA
Mailing Address - Zip Code:30308-2209
Mailing Address - Country:US
Mailing Address - Phone:404-885-7701
Mailing Address - Fax:404-885-7777
Practice Address - Street 1:833 CAMPBELL HILL ST NW
Practice Address - Street 2:SUITE 115
Practice Address - City:MARIETTA
Practice Address - State:GA
Practice Address - Zip Code:30060-1134
Practice Address - Country:US
Practice Address - Phone:770-427-3075
Practice Address - Fax:770-427-3261
Is Sole Proprietor?:Not Answered
Enumeration Date:2005-12-07
Last Update Date:2007-07-08
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
GA2504363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant
Provider Identifiers
StateIdentifier IDID TypeIssuer
GAS89394Medicare UPIN