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Organization

GEORGIA UROLOGY PEDIATRIC LLC

Active
Parent organization
GEORGIA UROLOGY
Other names
Georgia Urology
Organization subpart
Yes

Provider details

NPI number
Legal business name
GEORGIA UROLOGY
Authorized official
DR. MARK A HABER M.D. (MANAGING PARTNER)
(678) 284-4040
Entity
Organization

Contact information

Practice address
5730 GLENRIDGE DR, STE 200, ATLANTA, GA 30328-6141
(404) 256-1844
(404) 252-5642
Mailing address
1930 BRANNAN RD, MCDONOUGH, GA 30253-4310
(678) 284-4040
(678) 284-4076

Taxonomy

Speciality
Code
Description
License number
State
2088P0231X
Pediatric Urology Physician
Primary

Other

Enumeration date
02/17/2016
Last updated
02/17/2016
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