Organization
CENTER FOR VASCULAR INTERVENTION LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DOUGLAS C. REDD (OWNER)
(770) 538-1772
Entity
Organization
Contact information
Practice address
5505 PEACHTREE DUNWOODY RD STE 370, ATLANTA, GA 30342-1713
(770) 538-1772
(770) 538-1773
Mailing address
5505 PEACHTREE DUNWOODY RD STE 370, ATLANTA, GA 30342-1713
(770) 538-1772
(770) 538-1773
Taxonomy
Speciality
Code
Description
License number
State
2085R0204X
Vascular & Interventional Radiology Physician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1295256311
GROUP NPI
GA
01
—
4551596
AETNA/COVENTRY
GA
Enumeration date
06/28/2017
Last updated
10/31/2019
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