Provider Demographics
NPI:1285771253
Name:METROPOLITAN ATLANTA CARDIOLOGY CONSULTANTS
Entity type:Organization
Organization Name:METROPOLITAN ATLANTA CARDIOLOGY CONSULTANTS
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRACTICE ADMINISTRATOR
Authorized Official - Prefix:MS
Authorized Official - First Name:MARY ANN
Authorized Official - Middle Name:
Authorized Official - Last Name:MARTINEZ
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:404-874-1788
Mailing Address - Street 1:999 PEACHTREE ST NE
Mailing Address - Street 2:SUITE 850
Mailing Address - City:ATLANTA
Mailing Address - State:GA
Mailing Address - Zip Code:30309-3915
Mailing Address - Country:US
Mailing Address - Phone:404-874-1788
Mailing Address - Fax:404-872-4589
Practice Address - Street 1:999 PEACHTREE ST NE
Practice Address - Street 2:SUITE 850
Practice Address - City:ATLANTA
Practice Address - State:GA
Practice Address - Zip Code:30309-3915
Practice Address - Country:US
Practice Address - Phone:404-874-1788
Practice Address - Fax:404-872-4589
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-01-31
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GA207RC0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207RC0000XAllopathic & Osteopathic PhysiciansInternal MedicineCardiovascular DiseaseGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
GAGRP539Medicare PIN