GEORGIA UROLOGY PA (NPI# 1245250646) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1245250646 |
| Entity Type | Organization |
| Organization Name | GEORGIA UROLOGY PA |
| Practice Address |
33 Upper Riverdale Rd Sw Suite 105 Riverdale GA 30274-2626 |
| Mailing Address |
1930 Brannan Rd Mcdonough GA 30253-4310 |
| Practice Telephone | 7709910020 |
| Practice Fax Number | 7709949729 |
| Mailing Telephone | 6782844040 |
| Mailing Fax Number | 6782844076 |
| Enumeration Date | 2006-07-20 |
| Last Update Date | 2015-01-20 |
| Authorized Official Name | MARK A HABER (MANAGING PARTNER) |
| Authorized Official Telephone | 6782844049 |
| Authorized Official Credential | MD |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 208800000X | Urology | GA | Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| GA | GROUP NUMBER | GRP1552 | 01 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1265995724 | Georgia Urology Pa | Non-Pharmacy Dispensing Site | 5900 Hillandale Dr Ste 200, Lithonia, GA 30058-3858 | 2019-04-11 |
| 1447772348 | Georgia Urology Pa | Urology | 4800 Olde Towne Pkwy Ste 220, Marietta, GA 30068-4391 | 2017-07-12 |
| 1154855740 | Georgia Urology Pa | Urology | 2161 W Spring St., Suite C, Monroe, GA 30655-3196 | 2017-04-20 |
| 1720510241 | Georgia Urology Pa | Urology | 1110 W Peachtree St Nw Ste 1020, Atlanta, GA 30309-3609 | 2017-04-03 |
| 1184089989 | Georgia Urology Pa | Urology | 2151b West Spring St, Ste 210, Monroe, GA 30655-3115 | 2015-12-21 |
| 1528308988 | Georgia Urology Pa | Urology | 1357 Hembree Rd Ste 250, Roswell, GA 30076-5724 | 2013-02-21 |
| 1821261744 | Georgia Urology Pa | Urology | 200 Dawson Commons Circle, Dawsonville, GA 30534 | 2008-04-11 |
| 1508081795 | Georgia Urology Pa | Urology | 4645 Timber Ridge Dr Ste 120, Douglasville, GA 30135-7542 | 2007-04-15 |
| 1871144246 | Georgia Urology Pa | Urology | 1670 Scott Blvd Ste 204k, Decatur, GA 30033-5645 | 2019-09-26 |
| 1073028643 | Georgia Urology Pa | Urology | 4150 Deputy Bill Cantrell Memorial Road, Suite 140b, Cumming, GA 30040 | 2017-12-05 |
| Street Address |
33 UPPER RIVERDALE RD SW SUITE 105 |
| City | RIVERDALE |
| State | GA |
| Zip Code | 30274-2626 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1144226135 | Michael Angel Dicristina | Internal Medicine | 33 Upper Riverdale Rd Sw, Suite 21, Riverdale, GA 30274-2626 | 2005-06-23 |
| 1073028536 | Okeh Health Group, LLC | Clinic/Center | 33 Upper Riverdale Rd Sw, 17, Riverdale, GA 30274 | 2017-12-06 |
| 1275932998 | Southern Crescent Physicians Group, Inc. | Psychiatry & Neurology | 33 Upper Riverdale Rd Sw, Suite 112, Riverdale, GA 30274-2626 | 2014-08-19 |
| 1366841082 | Southern Crescent Physicians Group, Inc. | Surgery | 33 Upper Riverdale Rd Sw, Suite 121, Riverdale, GA 30274-2626 | 2014-08-19 |
| 1184023806 | Southern Crescent Physicians Group, Inc. | Surgery | 33 Upper Riverdale Rd Sw, Suite 17, Riverdale, GA 30274-2626 | 2014-08-19 |
| 1215341375 | Robin Alverson Inc | Audiologist | 33 Upper Riverdale Rd Sw, Ste 117, Riverdale, GA 30274-2642 | 2014-06-17 |
| 1811240054 | Richard A. Stappenbeck, M.d., P.C. | Psychiatry & Neurology | 33 Upper Riverdale Rd Sw, Suite 111, Riverdale, GA 30274-2626 | 2012-10-25 |
| 1255607628 | Minimally Invasive Neurospine and Pain Institute, PC | Clinic/Center | 33 Upper Riverdale Rd Sw, #25, Riverdale, GA 30274-2626 | 2012-03-29 |
| 1093995334 | Shaneeta Johnson | Surgery | 33 Upper Riverdale Rd Sw, Suite 121, Riverdale, GA 30274-2626 | 2007-11-04 |
| 1831391820 | Robin Pasquale Alverson | Audiologist | 33 Upper Riverdale Rd Sw, Suite 117, Riverdale, GA 30274-2626 | 2007-06-03 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1245862507 | Todd L. Reed | Chiropractor | 83 Upper Riverdale Rd, Riverdale, GA 30274 | 2020-02-05 |
| 1487135992 | Freddie L Sallette IIi | Technician, Pathology | 385 Brookview Dr, Riverdale, GA 30274 | 2018-08-22 |
| 1366933210 | Dawn A. Paul | Nurse Practitioner | 238 Professional Ct Ste A, Riverdale, GA 30274 | 2018-05-27 |
| 1851894588 | Absolute Health Family & Urgent Care Clinic | Clinic/Center | 7574 Ga 85, Riverdale, GA 30274 | 2018-03-08 |
| 1366972127 | Jamillah Ingram | Physical Therapy Assistant | 315 Upper Riverdale Rd., Riverdale, GA 30274 | 2017-06-14 |
| 1114456514 | Grace L Kelson | Licensed Practical Nurse | 9142 Clubhouse Dr, Riverdale, GA 30274 | 2017-06-08 |
| 1790167799 | Cristian Carbuccia | Internal Medicine | 33 Upper Riverdale Rd Sw Ste 10, Riverdale, GA 30274 | 2015-06-25 |
| 1265857692 | Right Choice Enterprises LLC | Technician | 638 Sterling Ct, Riverdale, GA 30274 | 2014-02-21 |
| 1942571625 | Lowes Guardian Angel LLC | Community Based Residential Treatment, Mental Retardation and/or Developmental Disabilities | 7056 Eunice Dr., Riverdale, GA 30274 | 2012-01-26 |
| 1508134156 | Education System Management, Inc | Social Worker | 125 Highway 138, Riverdale, GA 30274 | 2011-12-12 |
| Find all providers in zip 30274 | ||||
| Taxonomy Code | 208800000X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Urology |
| A urologist manages benign and malignant medical and surgical disorders of the genitourinary system and the adrenal gland. This specialist has comprehensive knowledge of and skills in endoscopic, percutaneous and open surgery of congenital and acquired conditions of the urinary and reproductive systems and their contiguous structures. |
| Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: definition added, source added] Additional Resources: American Board of Urology, 2007. http://www.abu.org/. Board certification for Medical Doctors (MDs) is provided by the American Board of Urology. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1497971329 | Georgia Urology Pa | Urology | 33 Upper Riverdale Rd Sw, Suite 105, Riverdale, GA 30274-2626 | 2007-04-18 |
| 1275612731 | Navin C Shah Md Pa | Urology | 4404 Queensbury Rd, #240, Riverdale, MD 20737 | 2006-11-03 |
| 1992891857 | Krishan G Gupta | Urology | 150 Medical Way, Riverdale, GA 30274 | 2006-10-05 |
| 1447368626 | Darrell J Carmen | Urology | 33 Upper Riverdale Rd Sw, Suite 105, Riverdale, GA 30274-2626 | 2006-08-28 |
| 1265441349 | Barry M Zisholtz | Urology | 33 Upper Riverdale Rd Sw, Suite 105, Riverdale, GA 30274-2626 | 2006-08-06 |
| 1801824933 | Zachary L Voeltz | Urology | 81 Upper Riverdale Rd Sw, Suite 200, Riverdale, GA 30274-2634 | 2006-06-29 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1942820576 | Advanced Urology Institute of Georgia PC | Urology | 2205 Riverstone Blvd Ste 101, Canton, GA 30114-5250 | 2020-04-23 |
| 1093369795 | Georgia Urology, Pa | Urology | 470 Northside Cherokee Blvd Ste 210, Canton, GA 30115-8029 | 2019-07-31 |
| 1790248953 | Michael Oberle | Urology | 1120 15th St Rm Baa 8415, Augusta, GA 30912-4050 | 2019-04-12 |
| 1598220915 | Effingham Urology, LLC | Urology | 613 Towne Park Dr W Ste 204, Rincon, GA 31326-5183 | 2019-02-11 |
| 1275008351 | Center for Special Surgery LLC | Urology | 11660 Alpharetta Hwy Ste 720, Roswell, GA 30076-4916 | 2018-10-04 |
| 1295200426 | Paul Edward Henson Jr. | Urology | 1837 Wood Valley Dr, Dalton, GA 30720-3846 | 2018-10-03 |
| 1477033124 | Urological Health Center, PC | Urology | 1770 Watson Boulevard, Warner Robins, GA 31093 | 2018-08-21 |
| 1982182655 | Advanced Urology Institute of Georgia | Urology | 1460 S Johnson Ferry Rd, Atlanta, GA 30319-4301 | 2018-08-03 |
| 1922597517 | Wguasc, LLC | Urology | 150 Clinic Ave Ste 203, Carrollton, GA 30117-4402 | 2018-05-09 |
| 1841788395 | Houston Physician Specialists, LLC | Urology | 233 N Houston Rd Ste 100, Warner Robins, GA 31093-8944 | 2018-04-30 |
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.