Provider Demographics
NPI:1457305732
Name:THE ATLANTA CARDIOLOGY GROUP PC
Entity type:Organization
Organization Name:THE ATLANTA CARDIOLOGY GROUP PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CREDENTIALING COORDINATOR
Authorized Official - Prefix:
Authorized Official - First Name:LAURA
Authorized Official - Middle Name:K
Authorized Official - Last Name:SOKOLOSKIS
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:404-845-2253
Mailing Address - Street 1:5665 PEACHTREE DUNWOODY RD NE
Mailing Address - Street 2:STE 172
Mailing Address - City:ATLANTA
Mailing Address - State:GA
Mailing Address - Zip Code:30342-1764
Mailing Address - Country:US
Mailing Address - Phone:404-845-2253
Mailing Address - Fax:404-255-9483
Practice Address - Street 1:5665 PEACHTREE DUNWOODY RD NE
Practice Address - Street 2:STE 172
Practice Address - City:ATLANTA
Practice Address - State:GA
Practice Address - Zip Code:30342-1764
Practice Address - Country:US
Practice Address - Phone:404-845-2253
Practice Address - Fax:404-255-9483
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-05-20
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207RC0000XAllopathic & Osteopathic PhysiciansInternal MedicineCardiovascular DiseaseGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
GAGRP1087Medicare ID - Type Unspecified