Basic Information
| Provider Information | |||||||||
| NPI: | 1104973064 | ||||||||
| EntityType: | 2 | ||||||||
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| OrganizationName: | ATLANTA PERINATAL ASSOCIATES | ||||||||
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| Mailing Information | |||||||||
| Address1: | 550 PEACHTREE STREET, NE | ||||||||
| Address2: | SUITE 1275 | ||||||||
| City: | ATLANTA | ||||||||
| State: | GA | ||||||||
| PostalCode: | 30308 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 4048723121 | ||||||||
| FaxNumber: | 4048723119 | ||||||||
| Practice Location | |||||||||
| Address1: | 550 PEACHTREE STREET, NE | ||||||||
| Address2: | SUITE 1275 | ||||||||
| City: | ATLANTA | ||||||||
| State: | GA | ||||||||
| PostalCode: | 30308 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 4048723121 | ||||||||
| FaxNumber: | 4048723119 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 01/04/2007 | ||||||||
| LastUpdateDate: | 09/15/2020 | ||||||||
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| AuthorizedOfficialLastName: | CULVER | ||||||||
| AuthorizedOfficialFirstName: | CARRIE | ||||||||
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| AuthorizedOfficialTitleorPosition: | PRACTICE ADMINISTRATOR | ||||||||
| AuthorizedOfficialTelephone: | 4048723121 | ||||||||
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| IsOrganizationSubpart: | N | ||||||||
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| NPICertificationDate: | 09/15/2020 | ||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 207VM0101X | Y | 193400000X SINGLE SPECIALTY GROUP | Allopathic & Osteopathic Physicians | Obstetrics & Gynecology | Maternal & Fetal Medicine |
ID Information
| ID | Type | State | Issuer | Description | 300033322D | 05 | GA | MEDICAID | 300033322E | 05 | GA | MEDICAID | 300033322F | 05 | GA | MEDICAID | 300033322B | 05 | GA | MEDICAID | 300033322G | 05 | GA | MEDICAID | 300033322H | 05 | GA | MEDICAID | 300033322A | 05 | GA | MEDICAID | 300033322C | 05 | GA | MEDICAID |