Provider Demographics
NPI:1972636652
Name:FERRI, EUGENE ROBERT JR (MD)
Entity Type:Individual
Prefix:
First Name:EUGENE
Middle Name:ROBERT
Last Name:FERRI
Suffix:JR
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3927 PINEHURST WAY
Mailing Address - Street 2:
Mailing Address - City:DULUTH
Mailing Address - State:GA
Mailing Address - Zip Code:30096-3172
Mailing Address - Country:US
Mailing Address - Phone:678-442-3317
Mailing Address - Fax:678-442-4416
Practice Address - Street 1:2292 PEACHTREE RD NW
Practice Address - Street 2:
Practice Address - City:ATLANTA
Practice Address - State:GA
Practice Address - Zip Code:30309
Practice Address - Country:US
Practice Address - Phone:404-382-9941
Practice Address - Fax:404-351-6762
Is Sole Proprietor?:No
Enumeration Date:2007-03-13
Last Update Date:2018-09-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GA026113207P00000X, 208D00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208D00000XAllopathic & Osteopathic PhysiciansGeneral Practice
No207P00000XAllopathic & Osteopathic PhysiciansEmergency Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
GA00308393BMedicaid
GA00308393BMedicaid
GAD39843Medicare UPIN