Provider Demographics
NPI:1871759951
Name:ATLANTA MIDTOWN GYNECOLOGY, INC
Entity type:Organization
Organization Name:ATLANTA MIDTOWN GYNECOLOGY, INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:MICHAEL
Authorized Official - Middle Name:FREDERICK
Authorized Official - Last Name:PERRY
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:404-685-8867
Mailing Address - Street 1:842 N HIGHLAND AVE NE
Mailing Address - Street 2:SUITE 250
Mailing Address - City:ATLANTA
Mailing Address - State:GA
Mailing Address - Zip Code:30306-4530
Mailing Address - Country:US
Mailing Address - Phone:404-685-8867
Mailing Address - Fax:404-685-8137
Practice Address - Street 1:842 N HIGHLAND AVE NE
Practice Address - Street 2:SUITE 250
Practice Address - City:ATLANTA
Practice Address - State:GA
Practice Address - Zip Code:30306-4530
Practice Address - Country:US
Practice Address - Phone:404-685-8867
Practice Address - Fax:404-685-8137
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-07-29
Last Update Date:2008-07-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GA046900174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes174400000XOther Service ProvidersSpecialistGroup - Single Specialty