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Organization
PEACHTREE VASCULAR ASSOCIATES, P.C.
Active
Organization
PEACHTREE VASCULAR ASSOCIATES, P.C.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. GEORGE MICHAEL SKARDASIS M.D. (PRESIDENT)
(404) 681-3190
Entity
Organization
Contact information
Practice address
550 PEACHTREE ST NE, SUITE 1085, ATLANTA, GA 30308-2232
(404) 681-3190
(404) 681-3193
Mailing address
550 PEACHTREE ST NE, SUITE 1085, ATLANTA, GA 30308-2247
(404) 681-3190
(404) 681-3193
Taxonomy
Speciality
Code
Description
License number
State
2086S0129X
Vascular Surgery Physician
Primary
—
NULL
2086S0129X
Vascular Surgery Physician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
00053633A
—
GA
01
—
020044829
MEDICARE RAILROAD
GA
01
—
1013082387
NPI
GA
01
—
17-05841
HEALTH FIRST
GA
01
—
212200
BLUE CROSS BLUE SHIELD
GA
01
—
253729461
CHAMPUS
GA
01
—
578663
AETNA
GA
01
—
GRP1615
MEDICARE
GA
Enumeration date
12/14/2006
Last updated
06/30/2010
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