Provider Demographics
NPI:1730199662
Name:PULMONARY ASSOCIATES, LLC
Entity type:Organization
Organization Name:PULMONARY ASSOCIATES, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:HATEM
Authorized Official - Middle Name:ABED
Authorized Official - Last Name:ASAD
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:478-922-8900
Mailing Address - Street 1:105 BRIARCLIFF RD
Mailing Address - Street 2:STE B
Mailing Address - City:WARNER ROBINS
Mailing Address - State:GA
Mailing Address - Zip Code:31088-4039
Mailing Address - Country:US
Mailing Address - Phone:478-922-8900
Mailing Address - Fax:478-922-8989
Practice Address - Street 1:105 BRIARCLIFF RD
Practice Address - Street 2:SUITE B
Practice Address - City:WARNER ROBINS
Practice Address - State:GA
Practice Address - Zip Code:31088-4039
Practice Address - Country:US
Practice Address - Phone:478-922-8900
Practice Address - Fax:478-922-8989
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-08-09
Last Update Date:2010-02-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GA049978207R00000X, 207RS0012X, 207RP1001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207RP1001XAllopathic & Osteopathic PhysiciansInternal MedicinePulmonary DiseaseGroup - Single Specialty
No207R00000XAllopathic & Osteopathic PhysiciansInternal MedicineGroup - Single Specialty
No207RS0012XAllopathic & Osteopathic PhysiciansInternal MedicineSleep MedicineGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
GAGRP6717Medicare ID - Type Unspecified