Organization
PIEDMONT ED PROFESSIONALS, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. CHRISTY AQUINO (DIRECTOR OF PROVIDER ENROLLMENT)
(470) 271-3427
Entity
Organization
Contact information
Practice address
1968 PEACHTREE RD NW, ATLANTA, GA 30309-1281
(404) 605-2800
(404) 351-5983
Mailing address
PO BOX 116750, ATLANTA, GA 30368-6750
(800) 926-3303
Taxonomy
Speciality
Code
Description
License number
State
207P00000X
Emergency Medicine Physician
Primary
11090929
GA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
003123631A
—
GA
Enumeration date
12/12/2011
Last updated
08/10/2021
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