Mak Anesthesia Decatur LLC

Primary specialty

Anesthesiology PhysicianTaxonomy code 207L00000X

License

51609 Issued in GA

Legal business name

MAK ANESTHESIA DECATUR LLC

Practice address

1457 Scott Blvd
Decatur, GA 30030-1425

Phone

(404) 292-2500

NPI assigned

Jan 2, 2014

Organization subpart

No

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

Authorized official

Name

Dr. Pamela Weigandt, MD

Title

President

Phone

(770) 702-1806

Specialties & licenses 1

Addresses

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

{
    "created_epoch": "1388620800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1477958400000",
    "number": "1720409147",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1635 OLD 41 HIGHWAY NW, SUITE 112-328",
            "city": "KENNESAW",
            "state": "GA",
            "postal_code": "30152",
            "telephone_number": "770-702-1806",
            "fax_number": "770-693-0810"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1457 SCOTT BLVD",
            "city": "DECATUR",
            "state": "GA",
            "postal_code": "300301425",
            "telephone_number": "404-292-2500"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MAK ANESTHESIA DECATUR LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2014-01-02",
        "last_updated": "2016-11-01",
        "status": "A",
        "authorized_official_last_name": "WEIGANDT",
        "authorized_official_first_name": "PAMELA",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "770-702-1806",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207L00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Anesthesiology",
            "state": "GA",
            "license": "51609",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Anesthesiology Physician in Decatur, GA
• Providers in Decatur, GA by specialty
• Anesthesiology Physician in Georgia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 1, 2016; 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.