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Rhonda
Taubin
MD
Contract Details
Shepherd Center
Facility name
Provider ID
P000001709
NPI
1144252610
Tax ID
510141601
Effective Date
6/15/2008
Last Updated
7/23/2018
Direct Contract
Yes
Status
Active
W9 Attachment
Contract Discounts
Discount Type
M
Exhibit ID
AM_389
AM_389
Location Details
Address
2020 Peachtree Road Northwest
Atlanta, GA 30309
United States
County
Fulton
Phone
4043522020
(
Phone
)
Billing Details
Address
2020 Peachtree Road Northwest
Atlanta, GA 30309
Billing Phone
4043522020
Specialty Type
Physical Medicine & Rehabilitation
Map
Address