Provider Demographics
NPI:1831803238
Name:ATLANTIC TELEHEALTH INC
Entity type:Organization
Organization Name:ATLANTIC TELEHEALTH INC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:ANDREW
Authorized Official - Middle Name:FORREST
Authorized Official - Last Name:KOHLER
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:571-249-2493
Mailing Address - Street 1:14820 LEE HWY
Mailing Address - Street 2:
Mailing Address - City:AMISSVILLE
Mailing Address - State:VA
Mailing Address - Zip Code:20106-4228
Mailing Address - Country:US
Mailing Address - Phone:571-249-2493
Mailing Address - Fax:
Practice Address - Street 1:14820 LEE HWY
Practice Address - Street 2:
Practice Address - City:AMISSVILLE
Practice Address - State:VA
Practice Address - Zip Code:20106-4228
Practice Address - Country:US
Practice Address - Phone:571-249-2493
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-01-10
Last Update Date:2023-07-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal MedicineGroup - Multi-Specialty
No261QE0002XAmbulatory Health Care FacilitiesClinic/CenterEmergency CareGroup - Multi-Specialty
No261QR0400XAmbulatory Health Care FacilitiesClinic/CenterRehabilitation
No261QR1300XAmbulatory Health Care FacilitiesClinic/CenterRural Health