Provider Demographics
NPI:1548247000
Name:CHILDREN'S ORTHOPAEDICS OF ATLANTA P.C.
Entity type:Organization
Organization Name:CHILDREN'S ORTHOPAEDICS OF ATLANTA P.C.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/PARTNER
Authorized Official - Prefix:
Authorized Official - First Name:MICHAEL
Authorized Official - Middle Name:T
Authorized Official - Last Name:BUSCH
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:404-255-1933
Mailing Address - Street 1:5445 MERIDIAN MARK ROAD
Mailing Address - Street 2:SUITE 250
Mailing Address - City:ATLANTA
Mailing Address - State:GA
Mailing Address - Zip Code:30342-4767
Mailing Address - Country:US
Mailing Address - Phone:404-255-1933
Mailing Address - Fax:404-256-7924
Practice Address - Street 1:5445 MERIDIAN MARK ROAD
Practice Address - Street 2:SUITE 250
Practice Address - City:ATLANTA
Practice Address - State:GA
Practice Address - Zip Code:30342
Practice Address - Country:US
Practice Address - Phone:404-255-1933
Practice Address - Fax:404-256-7924
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2005-12-27
Last Update Date:2016-08-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207X00000XAllopathic & Osteopathic PhysiciansOrthopaedic SurgeryGroup - Single Specialty