Organization
SOUTH ATLANTA MEDICAL CARE
Active
Organization subpart
No
Provider details
NPI number
Authorized official
TUSHAR NARROTTAM (MANAGER)
(404) 867-3584
Entity
Organization
Contact information
Practice address
6525 PROFESSIONAL PL STE B, RIVERDALE, GA 30274-2519
(404) 254-5496
(404) 254-5829
Mailing address
6525 PROFESSIONAL PL STE B, RIVERDALE, GA 30274-2519
(404) 254-5496
(404) 254-5829
Taxonomy
Speciality
Code
Description
License number
State
207KA0200X
Allergy Physician
20280
GA
207Q00000X
Family Medicine Physician
20280
GA
207R00000X
Internal Medicine Physician
20280
GA
2081P2900X
Pain Medicine (Physical Medicine & Rehabilitation) Physician
20280
GA
208D00000X
General Practice Physician
20280
GA
208VP0000X
Pain Medicine Physician
20280
GA
208VP0000X
Pain Medicine Physician
Primary
61081
GA
208VP0014X
Interventional Pain Medicine Physician
20280
GA
Other
Enumeration date
08/29/2011
Last updated
07/21/2022
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