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SOUTH ATLANTA DIGESTIVE DISEASES ASSOCIATES NPI 1841460490


NPI Information

NPI: 1841460490
Provider Name: SOUTH ATLANTA DIGESTIVE DISEASES ASSOCIATES
Classification: Internal Medicine - 207RG0100X
Entity Type: Organization

Specialization: Gastroenterology

CLIA Number: 11D1100488

Address:
1151 CLEVELAND AVE
SUITE D
EAST POINT, GA
ZIP 30344
Phone: (404) 761-7949
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SOUTH ATLANTA DIGESTIVE DISEASES ASSOCIATES is a gastroenterology internal medicine in East Point, GA. The provider is an internist who specializes in diagnosis and treatment of diseases of the digestive organs including the stomach, bowels, liver and gallbladder. This specialist treats conditions such as abdominal pain, ulcers, diarrhea, cancer and jaundice and performs complex diagnostic and therapeutic procedures using endoscopes to visualize internal organs. SOUTH ATLANTA DIGESTIVE DISEASES ASSOCIATES NPI is 1841460490. The provider is registered as an organization entity type and is a multiple single specialty group.

The provider's business location address is:

1151 CLEVELAND AVE
SUITE D
EAST POINT, GA
ZIP 30344-600
Phone: (404) 761-7949
Fax: (404) 761-7386

The provider's authorized official is Petronilla C Okere .
The authorized official title is Office Aministrator and has the following contact phone number (404) 761-7949.

The CLIA number assigned to this NPI record is 11D1100488 - physician office with a certificate type of Certificate of Waiver.

The enumeration date for this NPI number is 3/10/2008 and was last updated on 4/2/2024.


Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No. Taxonomy Code Taxonomy Clasification Taxonomy Specialization License Number License State Primary
1207R00000XInternal Medicine048686GEORGIANo
2207RG0100XInternal MedicineGastroenterology048686GEORGIAYes
3207RI0008XInternal MedicineHepatology048686GEORGIANo
4207RT0003XInternal MedicineTransplant Hepatology048686GEORGIANo

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No. Other Provider Identifier Other Provider Identifier Type Other Provider Identifier State Other Provider Identifier Issuer
1000893483CMEDICAIDGEORGIA
2003089OTHERGEORGIABCBS

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 5/5/2024

All materials and services on this site are provided on an "as is" and "as available" basis without warranty of any kind. The NPI record is maintained by the National Plan & Provider Enumeration System (NPPES) and anyone may request this information and other NPPES health care provider data from HHS under The Freedom of Information Act (FOIA), Title 5 of the United States Code, section 552. To update the NPI records please contact the NPPES.