1194120485 NPI number — MR. ARMANN ORN FENGER MS, LAPC

Table of content: MR. ARMANN ORN FENGER MS, LAPC (NPI 1194120485)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1194120485 NPI number — MR. ARMANN ORN FENGER MS, LAPC

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
FENGER
Provider First Name:
ARMANN
Provider Middle Name:
ORN
Provider Name Prefix Text:
MR.
Provider Name Suffix Text:
Provider Credential Text:
MS, LAPC
Provider Gender Code:
M

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1194120485
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
10/29/2014
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
9 DUNWOODY PARK
Provider Second Line Business Mailing Address:
SUITE 133
Provider Business Mailing Address City Name:
ATLANTA
Provider Business Mailing Address State Name:
GA
Provider Business Mailing Address Postal Code:
30338
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
678-561-7589
Provider Business Mailing Address Fax Number:
801-460-9414

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
230 HAMMOND DR
Provider Second Line Business Practice Location Address:
SUITE 330
Provider Business Practice Location Address City Name:
ATLANTA
Provider Business Practice Location Address State Name:
GA
Provider Business Practice Location Address Postal Code:
30328
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
678-561-7589
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
10/29/2014

Additional Information

Authorized Official

Authorized Official Last Name:
Authorized Official First Name:
Authorized Official Middle Name:
Authorized Official Title or Position:
Authorized Official Telephone Number:

Provider Taxonomy Codes

  • Taxonomy code: 101YP2500X ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)





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