Provider profile · NPI 1104679935

Advanced Anesthesia Care

Anesthesiology · Tucker, GA · NPI 1104679935 · No federal exclusion match

✔ Verified against the public CMS NPPES registry & HHS-OIG LEIE as of Jun 21, 2026. Source-linked, daily-refreshed. Public data only — no PHI.

Registry details

Type

Organization

Primary specialty

Anesthesiology

Enumerated

Apr 10, 2024

License(s)

Addresses on file

PurposeAddressCity/StatePhone
MAILINGPO BOX 956141 Duluth, GA 30095-9503678-459-4954
LOCATION1462 MONTREAL RD STE 109 Tucker, GA 30084-6904678-459-4954

View on NPPES registry ↗

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