Provider Demographics
NPI:1194048561
Name:PULMONARY AND SLEEP SPECIALISTS OF NORTHEAST GEORGIA, PC
Entity type:Organization
Organization Name:PULMONARY AND SLEEP SPECIALISTS OF NORTHEAST GEORGIA, PC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:RAMI
Authorized Official - Middle Name:B
Authorized Official - Last Name:ARFOOSH
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:770-586-0300
Mailing Address - Street 1:30 SATELLITE DR
Mailing Address - Street 2:SUITE 200
Mailing Address - City:WINDER
Mailing Address - State:GA
Mailing Address - Zip Code:30680-6211
Mailing Address - Country:US
Mailing Address - Phone:770-586-0300
Mailing Address - Fax:770-586-0311
Practice Address - Street 1:30 SATELLITE DR
Practice Address - Street 2:SUITE 200
Practice Address - City:WINDER
Practice Address - State:GA
Practice Address - Zip Code:30680-6211
Practice Address - Country:US
Practice Address - Phone:770-586-0300
Practice Address - Fax:770-586-0311
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-03-12
Last Update Date:2014-01-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207RP1001XAllopathic & Osteopathic PhysiciansInternal MedicinePulmonary DiseaseGroup - Multi-Specialty
No207R00000XAllopathic & Osteopathic PhysiciansInternal MedicineGroup - Multi-Specialty
No207RC0200XAllopathic & Osteopathic PhysiciansInternal MedicineCritical Care MedicineGroup - Multi-Specialty
No207RS0012XAllopathic & Osteopathic PhysiciansInternal MedicineSleep MedicineGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
GA063559OtherMEDICAL LICENSE