Organization
ADVANCED SLEEP LABORATORY-DUNWOODY
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. SAMUEL A MICKELSON MD (PHYSICIAN)
(404) 705-0855
Entity
Organization
Contact information
Practice address
960 JOHNSON FERRY RD NE, SUITE 200, ATLANTA, GA 30342-1631
(404) 705-0855
Mailing address
750 HAMMOND DR NE BLDG 19, SUITE 100, ATLANTA, GA 30328-6151
(404) 705-0855
Taxonomy
Speciality
Code
Description
License number
State
261QS1200X
Sleep Disorder Diagnostic Clinic/Center
Primary
159916
GA
Other
Enumeration date
11/15/2006
Last updated
01/09/2012
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