Metro Vascular, P.C.

Primary specialty

Legal MedicineTaxonomy code 173000000X

License

018771 Issued in GA

Legal business name

METRO VASCULAR, P.C.

Practice address

2675 N Decatur Rd Ste 210
Suite 210
Decatur, GA 30033-6132

Phone

(404) 292-5938

NPI assigned

Nov 12, 2007

Organization subpart

No

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

Authorized official

Name

Albert Wildstein, MD, M.D.

Title

Medical Director

Phone

(404) 292-5938

Specialties & licenses 1

Addresses

Locations

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

{
    "created_epoch": "1194825600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1195516800000",
    "number": "1891975470",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2675 N DECATUR RD",
            "address_2": "SUITE 210",
            "city": "DECATUR",
            "state": "GA",
            "postal_code": "300336131",
            "telephone_number": "404-292-5938"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2675 N DECATUR RD STE 210",
            "address_2": "SUITE 210",
            "city": "DECATUR",
            "state": "GA",
            "postal_code": "300336132",
            "telephone_number": "404-292-5938"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "METRO VASCULAR, P.C.",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-11-12",
        "last_updated": "2007-11-20",
        "status": "A",
        "authorized_official_last_name": "WILDSTEIN, MD",
        "authorized_official_first_name": "ALBERT",
        "authorized_official_title_or_position": "MEDICAL DIRECTOR",
        "authorized_official_telephone_number": "404-292-5938",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "173000000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Legal Medicine",
            "state": "GA",
            "license": "018771",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Legal Medicine in Decatur, GA
• Providers in Decatur, GA by specialty
• Legal Medicine in Georgia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 20, 2007; 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.