Provider Demographics
NPI:1316117740
Name:ORIAN MEDICAL GROUP INC
Entity type:Organization
Organization Name:ORIAN MEDICAL GROUP INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MR
Authorized Official - First Name:GUILLERMO
Authorized Official - Middle Name:
Authorized Official - Last Name:AVILES
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:678-234-0675
Mailing Address - Street 1:1874 PIEDMONT AVE NE
Mailing Address - Street 2:SUITE 390 C
Mailing Address - City:ATLANTA
Mailing Address - State:GA
Mailing Address - Zip Code:30324-4884
Mailing Address - Country:US
Mailing Address - Phone:404-249-8641
Mailing Address - Fax:404-249-8642
Practice Address - Street 1:1874 PIEDMONT AVE NE
Practice Address - Street 2:SUITE 390 C
Practice Address - City:ATLANTA
Practice Address - State:GA
Practice Address - Zip Code:30324-4884
Practice Address - Country:US
Practice Address - Phone:404-249-8641
Practice Address - Fax:404-249-8642
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-02-29
Last Update Date:2008-06-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208D00000XAllopathic & Osteopathic PhysiciansGeneral PracticeGroup - Multi-Specialty
No225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistGroup - Multi-Specialty