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Providence Healthcare
Clinical & Laboratory Immunology (Allergy & Immunology) Physician in Atlanta, Georgia
NPI 1699895961

Providence Healthcare is a Clinical & Laboratory Immunology (Allergy & Immunology) Physician based in Atlanta, GA and is specialized in Clinical & Laboratory Immunology. Providence Healthcare practices in Atlanta, GA. The NPI Number for Providence Healthcare is 1699895961 and holds a License No. CHIR005530 (Georgia).

The current practice location address for Providence Healthcare is 4646 N Shallowford Rd, Atlanta, GA and can be reached out via phone at 770-676-6000 and via fax at 770-392-9805.

Location: 4646 N Shallowford Rd, Atlanta, GA, 30338-6304
Profile Details Legacy Identifiers Practice Address Mailing Address Primary Taxonomy
institution
Provider Profile Details
NPI Number
1699895961
Provider Name
Providence Healthcare
Credential
Provider Entity Type
Organization
Address
4646 N Shallowford Rd, Atlanta, GA, 30338-6304
Phone Number
770-676-6000
Fax Number
770-392-9805
Provider Enumeration Date
03/30/2007
Last Update Date
03/09/2024
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Provider's Legacy Identifiers
Identifier Type State Issuer
50014615 01 GA TAT
826713 01 GA BLUECROSS BLUE SHIELD
D44849 01 GA UPIN
institution
Provider Business Practice Location Address Details
Address
4646 N Shallowford Rd
City
Atlanta
State
Georgia
Zip
30338-6304
Phone Number
770-676-6000
Fax Number
770-392-9805
person
Provider Business Mailing Address Details
Address
4646 N Shallowford Rd
City
Atlanta
State
Georgia
Zip
30338-6304
Phone Number
770-676-6000
Fax Number
770-392-9805
person
Provider's Taxonomy Details 1
Type
Chiropractic Providers
Classification
Chiropractor
Speciality
-
Taxonomy
111N00000X
License No.
(Georgia)
Definition
A provider qualified by a Doctor of Chiropractic (D.C.), licensed by the State and who practices chiropractic medicine -that discipline within the healing arts which deals with the nervous system and its relationship to the spinal column and its interrelationship with other body systems.
person
Provider's Taxonomy Details 2
Type
Other Service Providers
Classification
Acupuncturist
Speciality
-
Taxonomy
171100000X
License No.
000186 (Florida)
Definition
An acupuncturist is a person who performs ancient therapy for alleviation of pain, anesthesia and treatment of some diseases. Acupuncturists use long, fine needles inserted into specific points in order to treat painful conditions or produce anesthesia.
person
Provider's Taxonomy Details 3
Type
Allopathic & Osteopathic Physicians
Classification
Allergy & Immunology
Speciality
Clinical & Laboratory Immunology
Taxonomy
207KI0005X
License No.
CHIR005530 (Georgia)
Definition
Definition to come...
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