Basic Information
| Provider Information | |||||||||
| NPI: | 1548247000 | ||||||||
| EntityType: | 2 | ||||||||
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| OrganizationName: | CHILDREN'S ORTHOPAEDICS OF ATLANTA P.C. | ||||||||
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| Mailing Information | |||||||||
| Address1: | 5445 MERIDIAN MARK ROAD | ||||||||
| Address2: | SUITE 250 | ||||||||
| City: | ATLANTA | ||||||||
| State: | GA | ||||||||
| PostalCode: | 303424767 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 4042551933 | ||||||||
| FaxNumber: | 4042567924 | ||||||||
| Practice Location | |||||||||
| Address1: | 5445 MERIDIAN MARK ROAD | ||||||||
| Address2: | SUITE 250 | ||||||||
| City: | ATLANTA | ||||||||
| State: | GA | ||||||||
| PostalCode: | 30342 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 4042551933 | ||||||||
| FaxNumber: | 4042567924 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 12/27/2005 | ||||||||
| LastUpdateDate: | 08/23/2016 | ||||||||
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| AuthorizedOfficialLastName: | BUSCH | ||||||||
| AuthorizedOfficialFirstName: | MICHAEL | ||||||||
| AuthorizedOfficialMiddleName: | T | ||||||||
| AuthorizedOfficialTitleorPosition: | OWNER/PARTNER | ||||||||
| AuthorizedOfficialTelephone: | 4042551933 | ||||||||
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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 | 207X00000X | Y | 193400000X SINGLE SPECIALTY GROUP | Allopathic & Osteopathic Physicians | Orthopaedic Surgery |
No ID Information.