Provider Demographics
NPI:1699450098
Name:ATLANTAMED UC LLC
Entity type:Organization
Organization Name:ATLANTAMED UC LLC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:CO OWNER
Authorized Official - Prefix:
Authorized Official - First Name:ANTHONY
Authorized Official - Middle Name:
Authorized Official - Last Name:FERRARA
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:404-992-6144
Mailing Address - Street 1:4113 BARRY PL
Mailing Address - Street 2:
Mailing Address - City:CHAMBLEE
Mailing Address - State:GA
Mailing Address - Zip Code:30341-1203
Mailing Address - Country:US
Mailing Address - Phone:770-588-3230
Mailing Address - Fax:
Practice Address - Street 1:11912 JONES BRIDGE RD
Practice Address - Street 2:
Practice Address - City:ALPHARETTA
Practice Address - State:GA
Practice Address - Zip Code:30005-4613
Practice Address - Country:US
Practice Address - Phone:678-990-1831
Practice Address - Fax:404-937-6299
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-06-21
Last Update Date:2023-08-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily MedicineGroup - Multi-Specialty
No261QU0200XAmbulatory Health Care FacilitiesClinic/CenterUrgent CareGroup - Multi-Specialty