Organization
FAYETTE COMMUNITY ANESTHESIA
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. MIKE KOLESAR (PRACTICE ADMINISTRATOR)
(404) 351-1745
Entity
Organization
Contact information
Practice address
1984 PEACHTREE RD NW, SUITE 515, ATLANTA, GA 30309-1298
(404) 351-1745
Mailing address
PO BOX 7836, MARIETTA, GA 30065-1836
(678) 202-2060
Taxonomy
Speciality
Code
Description
License number
State
207L00000X
Anesthesiology Physician
Primary
—
GA
Other
Enumeration date
07/29/2005
Last updated
08/22/2020
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