Organization
SURGICAL ASSISTANTS OF AMERICA, INC.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. DAN CAVALLARO (CEO)
(678) 957-8801
Entity
Organization
Contact information
Practice address
3400 MCCLURE BRIDGE RD, BUILDING B201, DULUTH, GA 30096-6675
(678) 957-8801
(678) 957-8804
Mailing address
3400 MCCLURE BRIDGE RD, BUILDING B201, DULUTH, GA 30096-6675
(678) 957-8801
(678) 957-8804
Taxonomy
Speciality
Code
Description
License number
State
208600000X
Surgery Physician
015910
GA
208600000X
Surgery Physician
028757
GA
208600000X
Surgery Physician
Primary
058760
GA
363AS0400X
Surgical Physician Assistant
000870
GA
363AS0400X
Surgical Physician Assistant
003284
GA
363AS0400X
Surgical Physician Assistant
003394
GA
363AS0400X
Surgical Physician Assistant
003653
GA
363AS0400X
Surgical Physician Assistant
003970
GA
363AS0400X
Surgical Physician Assistant
004703
GA
363AS0400X
Surgical Physician Assistant
004761
GA
363AS0400X
Surgical Physician Assistant
004785
GA
363AS0400X
Surgical Physician Assistant
005133
GA
363AS0400X
Surgical Physician Assistant
005631
GA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1417977885
BCBS
GA
05
—
1417977885
—
GA
Enumeration date
07/20/2006
Last updated
06/17/2011
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