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Sara
Nash
MD
Contract Details
AmeriPath
Facility name
Provider ID
P000006709
NPI
1164560876
Tax ID
581267100
Effective Date
5/16/2012
Last Updated
5/21/2017
Direct Contract
Yes
Status
Active
W9 Attachment
Contract Discounts
Discount Type
S
State Fee Schedule Multiplier
80.00
Location Details
Address
Atlanta GI 2275 Northwest Parkway, Suite 140
Marietta, GA 300679321
United States
County
Cobb
Phone
7709511793
(
Phone
)
Billing Details
Address
PO Box 100191
Atlanta, GA 303840191
Billing Phone
4075874457
Specialty Type
Pathology, Clinical
Map
Address