Organization
GEMINI SURGICAL SERVICES, INC.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
AMANDA VON DER SCHULENBURG (OWNER/PRESIDENT)
(678) 951-4576
Entity
Organization
Contact information
Practice address
1307 W GARMON RD, ATLANTA, GA 30327-4405
(678) 951-4576
Mailing address
1307 W GARMON RD, ATLANTA, GA 30327-4405
Taxonomy
Speciality
Code
Description
License number
State
363AS0400X
Surgical Physician Assistant
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1619951985
—
GA
Enumeration date
10/19/2018
Last updated
10/19/2018
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