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Organization

GEORGIA REGIONAL UROLOGY PC

Active
Organization subpart
No

Provider details

NPI number
Authorized official
DAVID L PERLOW MD (MEDICAL DOCTOR)
(770) 951-0866
Entity
Organization

Contact information

Practice address
2520 WINDY HILL RD SE, SUITE 305, MARIETTA, GA 30067-8664
(770) 951-0866
(770) 951-1688
Mailing address
2520 WINDY HILL RD SE, SUITE 305, MARIETTA, GA 30067-8664
(770) 951-0866
(770) 951-1688

Taxonomy

Speciality
Code
Description
License number
State
208800000X
Urology Physician
Primary
GA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
0621780001
DMERC
GA
01
7280346
AETNA
GA
01
CL8362
RAILROAD MEDICARE
GA
Enumeration date
01/16/2007
Last updated
12/30/2009
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