Unknown Individual – Specialist, NPI 1073511788
Specialist
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Profile Insights
NPPES metrics only — not quality of care.
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Provider Addresses for Unknown Individual
130, Halstead Court, Seven Pines, Alpharetta, Fulton, Georgia, 30022, United States
ALPHARETTA, GA 300055211
Phone: (678) 206-2589
Fax: (678) 261-1713
Type: Mailing
Preston Ridge Road, Country Place, Preston Ridge, Alpharetta, Fulton, Georgia, 300009, United States
ALPHARETTA, GA 300054540
Phone: (770) 740-1860
Fax: (678) 347-2104
Type: Location
910 NE 26th Ave
Fort Lauderdale, FL 333043607
Phone: (954) 565-8282
Fax: (954) 565-8994
Type: Location
NPPES updates history
No NPPES updates recorded for this provider.
Prescription Activity
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Open Payments (CMS)
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Medicare Enrollment & Revalidation
Source: CMS public data · Not endorsed by CMS ·
Educational use only—not medical, billing, or legal advice.
No Medicare enrollment or revalidation data available for this provider in our database.
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Medicare Utilization (FFS)
Source: CMS public data · Not endorsed by CMS · Beneficiary counts under 11 are suppressed in source data ·
Educational use only—not medical, billing, or legal advice.
No Medicare fee-for-service utilization data available for this provider in our database.
Insurance plans in this area (ZIP 30005)
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