Basic Information
| Provider Information | |||||||||
| NPI: | 1174733745 | ||||||||
| EntityType: | 2 | ||||||||
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| OrganizationName: | ALAN M. HARBEN M.D. PHD PC | ||||||||
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| Mailing Information | |||||||||
| Address1: | PO BOX 724928 | ||||||||
| Address2: | |||||||||
| City: | ATLANTA | ||||||||
| State: | GA | ||||||||
| PostalCode: | 311939028 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 6788381585 | ||||||||
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| Practice Location | |||||||||
| Address1: | 11775 POINTE PL STE 103 | ||||||||
| Address2: | |||||||||
| City: | ROSWELL | ||||||||
| State: | GA | ||||||||
| PostalCode: | 300764652 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 6788381585 | ||||||||
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| Other Information | |||||||||
| ProviderEnumerationDate: | 05/23/2007 | ||||||||
| LastUpdateDate: | 02/24/2010 | ||||||||
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| AuthorizedOfficialLastName: | HARBEN | ||||||||
| AuthorizedOfficialFirstName: | ALAN | ||||||||
| AuthorizedOfficialMiddleName: | M | ||||||||
| AuthorizedOfficialTitleorPosition: | OWNER/PHYSICIAN | ||||||||
| AuthorizedOfficialTelephone: | 7706190010 | ||||||||
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| IsOrganizationSubpart: | N | ||||||||
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| AuthorizedOfficialCredential: | MD | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 2081P2900X | 029664 | GA | Y | 193400000X SINGLE SPECIALTY GROUP | Allopathic & Osteopathic Physicians | Physical Medicine & Rehabilitation | Pain Medicine |
No ID Information.