Basic Information
Provider Information
NPI: 1962407023
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: BEER
FirstName: SALLY
MiddleName: G.
NamePrefix:  
NameSuffix:  
Credential: MD
OtherOrganizationName:  
OtherOrganizationType:  
OtherLastName:  
OtherFirstName:  
OtherMiddleName:  
OtherNamePrefix:  
OtherNameSuffix:  
OtherCredential:  
OtherLastNameType:  
Mailing Information
Address1: 275 COLLIER ROAD, NW
Address2: STE 300
City: ATLANTA
State: GA
PostalCode: 303091740
CountryCode: US
TelephoneNumber: 4046052800
FaxNumber: 4043515983
Practice Location
Address1: 275 COLLIER ROAD, NW
Address2: STE 300
City: ATLANTA
State: GA
PostalCode: 303091740
CountryCode: US
TelephoneNumber: 4046052800
FaxNumber: 4043515983
Other Information
ProviderEnumerationDate: 06/16/2005
LastUpdateDate: 09/20/2010
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: F
AuthorizedOfficialLastName:  
AuthorizedOfficialFirstName:  
AuthorizedOfficialMiddleName:  
AuthorizedOfficialTitleorPosition:  
AuthorizedOfficialTelephone:  
IsSoleProprietor: N
IsOrganizationSubpart:  
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate:  

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
207RC0000X034295GAN Allopathic & Osteopathic PhysiciansInternal MedicineCardiovascular Disease
207UN0901X034295GAY Allopathic & Osteopathic PhysiciansNuclear MedicineNuclear Cardiology

ID Information
IDTypeStateIssuerDescription
000456882JKLM05GA MEDICAID


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