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Organization

EASTSIDE SURGICAL ASSISTANTS LLC

Active
Organization subpart
No

Provider details

NPI number
Authorized official
MR. SAMUEL FENDERSON (CERTIFIED SURGICAL ASSISTANT)
(678) 799-2498
Entity
Organization

Contact information

Practice address
925 MAIN ST, SUITE 300-07, STONE MOUNTAIN, GA 30083-3098
(678) 799-2498
Mailing address
925 MAIN ST, SUITE 300-07, STONE MOUNTAIN, GA 30083-3098
(678) 799-2498

Taxonomy

Speciality
Code
Description
License number
State
246ZC0007X
Surgical Assistant
Primary

Other

Enumeration date
09/30/2015
Last updated
09/30/2015
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