Organization
SLEEPMED INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
JOSEPH ROSE (VP OF FINANCE & ADMINISTRATION)
(978) 536-7400
Entity
Organization
Contact information
Practice address
435 SECOND ST, SUITE 430, MACON, GA 31201-2624
(478) 745-5779
(478) 742-7796
Mailing address
60 CHASTAIN CENTER BLVD NW, STE 66, KENNESAW, GA 30144-5598
(978) 536-7400
Taxonomy
Speciality
Code
Description
License number
State
207RS0012X
Sleep Medicine (Internal Medicine) Physician
Primary
—
—
2084N0400X
Neurology Physician
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
2860022
AETNA HMO
—
01
—
7618325
AETNA PPO
—
Enumeration date
01/03/2008
Last updated
05/17/2016
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