Organization
CANCER CARE SPECIALISTS, P.C.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
TOSHA BALFOUR M.D. (OWNER PHYSICIAN)
(404) 501-6925
Entity
Organization
Contact information
Practice address
2675 N DECATUR RD, SUITE G03, DECATUR, GA 30033
(404) 501-6925
(404) 501-6930
Mailing address
PO BOX 98446, ATLANTA, GA 30359
(404) 423-8881
(404) 321-0223
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
048205
GA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
GRP8109
MEDICARE GROUP NUMBER
GA
Enumeration date
05/03/2007
Last updated
11/16/2007
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