Organization · Type 2 NPI

Edg Sports Medicine,inc

Surgical Physician Assistant · Decatur, GA

NPI number 1114169703 Active

Practice location

2801 N Decatur Rd, Suite 200
Decatur, GA 30033-5949

Call (404) 296-5005 Map

Fax (404) 296-5058

Mailing address

1230 Briarvista Way
Atlanta, GA 30329

Specialties and licenses

TaxonomyCodeLicense
Surgical Physician Assistant Primary 363AS0400X1857 (GA)

Surgical Physician Assistant: Definition to come...

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About NPI 1114169703

Edg Sports Medicine,inc's National Provider Identifier is 1114169703, issued on Mar 30, 2009. The primary taxonomy on file is Surgical Physician Assistant (363AS0400X), and the practice location is in Decatur, GA. The record was last updated on Mar 30, 2009.