Organization
NORTHEAST GEORGIA VASCULAR CENTER
Active
Other names
Vascular Clinics of Northeast Georgia
Organization subpart
No
Provider details
NPI number
Authorized official
MICHAEL H LEBOW M.D. (OWNER)
(770) 535-1948
Entity
Organization
Contact information
Practice address
4763 SHIRLEY RD, GAINESVILLE, GA 30506-5108
(770) 535-1948
(770) 535-1488
Mailing address
4763 SHIRLEY RD, GAINESVILLE, GA 30506-5108
(770) 535-1948
(770) 535-1488
Taxonomy
Speciality
Code
Description
License number
State
305R00000X
Preferred Provider Organization
Primary
61114
GA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1942553359
NPI
GA
Enumeration date
10/23/2012
Last updated
02/18/2013
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