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Organization
VASCULAR INSTITUTE OF GEORGIA, PC
Active
Organization
VASCULAR INSTITUTE OF GEORGIA, PC
Active
Other names
Vascular Insitute of Georiga, PC
Organization subpart
No
Provider details
NPI number
Authorized official
MR. MARK J MITTENTHAL M.D. (PHYSICIAN)
(404) 256-0404
Entity
Organization
Contact information
Practice address
5669 PEACHTREE DUNWOODY RD NE, SUITE 100, ATLANTA, GA 30342-1786
(404) 256-0404
(404) 847-0423
Mailing address
5669 PEACHTREE DUNWOODY RD NE, SUITE 100, ATLANTA, GA 30342-1786
(404) 256-0404
(404) 847-0423
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
—
00206005I
—
GA
05
—
00216466H
—
GA
05
—
00460039E
—
GA
01
—
1033184767
J. MARK RHEUDASIL
GA
01
—
1376517300
ALAN KOORNICK
GA
01
—
1528028925
MICHAEL D. CLARK
GA
01
—
1598739559
MARK MITTENTHAL
GA
01
—
1629038476
PETER H'DOUBLER JR.
GA
01
—
1861466955
MARK G. COAN
GA
Enumeration date
05/03/2006
Last updated
08/22/2020
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