Provider Demographics
NPI:1447370234
Name:ALBERT F.JOHARY MD, PC
Entity type:Organization
Organization Name:ALBERT F.JOHARY MD, PC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:DOCTOR
Authorized Official - Prefix:DR
Authorized Official - First Name:ALBERT
Authorized Official - Middle Name:F
Authorized Official - Last Name:JOHARY
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:770-730-8908
Mailing Address - Street 1:1320 CENTER DR STE 100
Mailing Address - Street 2:
Mailing Address - City:DUNWOODY
Mailing Address - State:GA
Mailing Address - Zip Code:30338-4130
Mailing Address - Country:US
Mailing Address - Phone:770-730-8908
Mailing Address - Fax:770-730-8230
Practice Address - Street 1:1320 CENTER DR STE 100
Practice Address - Street 2:
Practice Address - City:DUNWOODY
Practice Address - State:GA
Practice Address - Zip Code:30338-4130
Practice Address - Country:US
Practice Address - Phone:770-730-8908
Practice Address - Fax:770-730-8230
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-03-29
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GA034862261Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261Q00000XAmbulatory Health Care FacilitiesClinic/Center
Provider Identifiers
StateIdentifier IDID TypeIssuer
GAF53293Medicare UPIN