Provider Demographics
NPI:1831382357
Name:ATLANTA PSYCHIATRIC SPECILIASTS, P.C.
Entity type:Organization
Organization Name:ATLANTA PSYCHIATRIC SPECILIASTS, P.C.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MEDICAL DIRECTOR
Authorized Official - Prefix:DR
Authorized Official - First Name:ROSS
Authorized Official - Middle Name:F
Authorized Official - Last Name:GRUMET
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:404-685-9414
Mailing Address - Street 1:1718 PEACHTREE ST NW
Mailing Address - Street 2:SUITE 1080
Mailing Address - City:ATLANTA
Mailing Address - State:GA
Mailing Address - Zip Code:30309-2452
Mailing Address - Country:US
Mailing Address - Phone:404-685-9414
Mailing Address - Fax:404-685-9420
Practice Address - Street 1:1718 PEACHTREE ST NW
Practice Address - Street 2:SUITE 1080
Practice Address - City:ATLANTA
Practice Address - State:GA
Practice Address - Zip Code:30309-2452
Practice Address - Country:US
Practice Address - Phone:404-685-9414
Practice Address - Fax:404-685-9420
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-08-20
Last Update Date:2007-08-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GA011596174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes174400000XOther Service ProvidersSpecialistGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
GAGRP514Medicare PIN