Provider Demographics
NPI:1992772164
Name:ATLANTA WOMEN'S OBSTETRICS & GYNECOLOGY, PC
Entity type:Organization
Organization Name:ATLANTA WOMEN'S OBSTETRICS & GYNECOLOGY, PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRACTICE ADMINISTRATOR
Authorized Official - Prefix:
Authorized Official - First Name:CHERIS
Authorized Official - Middle Name:
Authorized Official - Last Name:CRAIG
Authorized Official - Suffix:
Authorized Official - Credentials:MBA CMPE
Authorized Official - Phone:404-352-3616
Mailing Address - Street 1:275 COLLIER RD NW
Mailing Address - Street 2:SUITE 230
Mailing Address - City:ATLANTA
Mailing Address - State:GA
Mailing Address - Zip Code:30309-1704
Mailing Address - Country:US
Mailing Address - Phone:404-352-3616
Mailing Address - Fax:404-352-2028
Practice Address - Street 1:275 COLLIER RD NW
Practice Address - Street 2:SUITE 230
Practice Address - City:ATLANTA
Practice Address - State:GA
Practice Address - Zip Code:30309-1704
Practice Address - Country:US
Practice Address - Phone:404-352-3616
Practice Address - Fax:404-352-2028
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-03-07
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & GynecologyGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
GRP3893Medicare ID - Type UnspecifiedGROUP MEDICARE NUMBER