Alan M. Harben M.D. PHD PC

Organization Active NPI Pain Medicine (Physical Medicine & Rehabilitation) Physician · Roswell, GA

NPI 1174733745 · NPPES record last updated Feb 24, 2010

Key facts

NPI
1174733745
Entity type
Organization (NPI type 2)
Primary specialty
Pain Medicine (Physical Medicine & Rehabilitation) Physician 2081P2900X
License
029664 (GA)
Legal business name
ALAN M. HARBEN M.D. PHD PC
Practice address
11775 Pointe PL Ste 103
Roswell, GA 30076-4652
Phone
(678) 838-1585
NPI assigned
May 23, 2007
Organization subpart
No

Authorized official

Name
Alan M Harben, MD
Title
Owner/Physician
Phone
(770) 619-0010

Corporate family (same tax ID) 1

Organizations that report the same tax identification number in the National Provider Directory.

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

Medicare participation

Medicare fee-for-service enrollment
Enrolled in GA

Medicare enrollment records

Enrollment IDStateProvider typePAC IDDetails
O20040930000529 GA Part B Supplier - Clinic/Group Practice 9032188552 Receives reassigned benefits from 1 practitioner
Practice locations: Roswell, GA

National Provider Directory

Tax ID family
Alan M Harben MD PHD (2 organizations share this tax ID)

Locations

3215 McClure Bridge Rd
Duluth, GA 30096
Phone (678) 312-6000

11180 Crabapple Rd
Roswell, GA 30075
Phone (678) 277-9275

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Pain Medicine (Physical Medicine & Rehabilitation) Physician
Group: 193400000X SINGLE SPECIALTY GROUP
2081P2900X 029664 GA Yes

Addresses

Primary practice location

11775 Pointe PL Ste 103
Roswell, GA 30076-4652

Mailing address

PO Box 724928
Atlanta, GA 31193-9028
Phone (678) 838-1585

Other providers in Roswell, GA

All providers in Roswell, GA · Pain Medicine (Physical Medicine & Rehabilitation) Physician in Georgia

Sources for this page

Verify at the official NPI Registry.