Provider Demographics
NPI:1487762795
Name:ATLANTA OBSTETRICS AND FAMILY CARE, P.C.
Entity type:Organization
Organization Name:ATLANTA OBSTETRICS AND FAMILY CARE, P.C.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT/OWNER
Authorized Official - Prefix:
Authorized Official - First Name:BELKIS
Authorized Official - Middle Name:
Authorized Official - Last Name:PIMENTEL
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:404-305-8900
Mailing Address - Street 1:PO BOX 411
Mailing Address - Street 2:
Mailing Address - City:TYRONE
Mailing Address - State:GA
Mailing Address - Zip Code:30290-0411
Mailing Address - Country:US
Mailing Address - Phone:404-305-8900
Mailing Address - Fax:
Practice Address - Street 1:1203 CLEVELAND AVE
Practice Address - Street 2:SUITE 1A
Practice Address - City:EAST POINT
Practice Address - State:GA
Practice Address - Zip Code:30344-3417
Practice Address - Country:US
Practice Address - Phone:404-305-8900
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-08-27
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GA043110261QM2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QM2500XAmbulatory Health Care FacilitiesClinic/CenterMedical Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
GAG81694Medicare UPIN