Provider Demographics
NPI:1588321970
Name:ATLANTA PM&R INC
Entity type:Organization
Organization Name:ATLANTA PM&R INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OFFICER
Authorized Official - Prefix:DR
Authorized Official - First Name:UGO
Authorized Official - Middle Name:
Authorized Official - Last Name:BITUSSI
Authorized Official - Suffix:
Authorized Official - Credentials:DO
Authorized Official - Phone:404-444-2254
Mailing Address - Street 1:1595 PEACHTREE PKWY STE 204
Mailing Address - Street 2:#397
Mailing Address - City:CUMMING
Mailing Address - State:GA
Mailing Address - Zip Code:30041-2040
Mailing Address - Country:US
Mailing Address - Phone:404-938-9618
Mailing Address - Fax:
Practice Address - Street 1:601 NORTHOLT PKWY
Practice Address - Street 2:
Practice Address - City:SUWANEE
Practice Address - State:GA
Practice Address - Zip Code:30024-4360
Practice Address - Country:US
Practice Address - Phone:770-904-3222
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2021-11-21
Last Update Date:2023-06-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208100000XAllopathic & Osteopathic PhysiciansPhysical Medicine & RehabilitationGroup - Single Specialty