1629110796 NPI number — ATLANTA WOMEN'S OBSTETRICS & GYNECOLOGY II, LLC

Table of content: MRS. MICHELE ANN SEASLY ACSW CAC1 LMSW (NPI 1144356569)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1629110796 NPI number — ATLANTA WOMEN'S OBSTETRICS & GYNECOLOGY II, LLC

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
ATLANTA WOMEN'S OBSTETRICS & GYNECOLOGY II, LLC
Provider Last Name:
Provider First Name:
Provider Middle Name:
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
Provider Gender Code:

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:
1629110796
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
08/22/2020
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
PO BOX 468329
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
ATLANTA
Provider Business Mailing Address State Name:
GA
Provider Business Mailing Address Postal Code:
31146-8329
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
404-943-0205
Provider Business Mailing Address Fax Number:

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
275 COLLIER RD NW
Provider Second Line Business Practice Location Address:
SUITE 230
Provider Business Practice Location Address City Name:
ATLANTA
Provider Business Practice Location Address State Name:
GA
Provider Business Practice Location Address Postal Code:
30309-1704
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
404-352-3616
Provider Business Practice Location Address Fax Number:
404-352-2028
Provider Enumeration Date:
02/13/2007

Additional Information

Authorized Official

Authorized Official Last Name:
WILLIAMS
Authorized Official First Name:
CYD
Authorized Official Middle Name:
G
Authorized Official Title or Position:
PRESIDENT
Authorized Official Telephone Number:
404-352-3616

Provider Taxonomy Codes

  • Taxonomy code: 207VX0000X ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

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





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