Peachstate Orthopedics

Primary specialty

SpecialistTaxonomy code 174400000X

License

036312 Issued in GA

Legal business name

PEACHSTATE ORTHOPEDICS

Practice address

211 Prime PT
Suite 2H
Peachtree City, GA 30269-3334

Phone

(770) 631-6410

NPI assigned

Sep 15, 2008

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Steven Merritt Wanderman, M.D.

Title

President

Phone

(770) 631-6410

Specialties & licenses 1

Addresses

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1221436800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1221436800000",
    "number": "1528217544",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "211 PRIME PT",
            "address_2": "SUITE 2H",
            "city": "PEACHTREE CITY",
            "state": "GA",
            "postal_code": "302693334",
            "telephone_number": "770-631-6410"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "211 PRIME PT",
            "address_2": "SUITE 2H",
            "city": "PEACHTREE CITY",
            "state": "GA",
            "postal_code": "302693334",
            "telephone_number": "770-631-6410"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PEACHSTATE ORTHOPEDICS",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-09-15",
        "last_updated": "2008-09-15",
        "status": "A",
        "authorized_official_last_name": "WANDERMAN",
        "authorized_official_first_name": "STEVEN",
        "authorized_official_middle_name": "MERRITT",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "770-631-6410",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "174400000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Specialist",
            "state": "GA",
            "license": "036312",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Specialist in Peachtree City, GA
• Providers in Peachtree City, GA by specialty
• Specialist in Georgia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 15, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.