| Dr Mark P Cruz, MD | |
|
3950 Austell Rd, Austell, GA 30106-1121 | |
| (770) 732-4000 | |
| Not Available |
| Full Name | Dr Mark P Cruz |
|---|---|
| Gender | Male |
| Speciality | Emergency Medicine |
| Location | 3950 Austell Rd, Austell, Georgia |
| Accepts Medicare Assignments | Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs. |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1033223227 | NPI | - | NPPES |
| 00855313G | Medicaid | GA | |
| 350077800 | Other | GA | DOL |
| 00855313H | Medicaid | GA | |
| 00855313F | Medicaid | GA | |
| 00855313J | Medicaid | GA |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207P00000X | Emergency Medicine | 047969 (Georgia) | Primary |
| Entity Name | Acs Primary Care Physicians - Southeast Pc |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1861430555 PECOS PAC ID: 5193620714 Enrollment ID: O20040901000766 |
| Entity Name | The Bortolazzo Group, Llc |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1801965082 PECOS PAC ID: 3476554320 Enrollment ID: O20070122000015 |
| Entity Name | Angelfish Emergency Physicians Llc |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1407259500 PECOS PAC ID: 7517282817 Enrollment ID: O20150209000684 |
| Mailing Address | Practice Location Address |
|---|---|
| Dr Mark P Cruz, MD 5665 New Northside Dr Nw, Suite 320, Atlanta, GA 30328-5831 Ph: (770) 874-5400 | Dr Mark P Cruz, MD 3950 Austell Rd, Austell, GA 30106-1121 Ph: (770) 732-4000 |
Michelle Presley, Emergency Medicine Medicare: Medicare Enrolled Practice Location: 3950 Austell Rd, Austell, GA 30106 Phone: 770-732-4000 | |
Dr. Zachary Richard Wetendorf, M.D. Emergency Medicine Medicare: Accepting Medicare Assignments Practice Location: 3950 Austell Rd, Austell, GA 30106 Phone: 770-732-3886 Fax: 770-732-7280 | |
Dr. Craig S Brummer, MD Emergency Medicine Medicare: Medicare Enrolled Practice Location: 3950 Austell Rd, Austell, GA 30106 Phone: 770-732-4000 | |
Kirsten Haskelle Bendeck, MD Emergency Medicine Medicare: Medicare Enrolled Practice Location: 3950 Austell Road, Emergency Department, Austell, GA 30328 Phone: 770-732-4000 | |
Gerald Bortolazzo, Emergency Medicine Medicare: Not Enrolled in Medicare Practice Location: 3950 Austell Rd, Austell, GA 30106 Phone: 770-732-4000 | |
William Pearl, Emergency Medicine Medicare: Medicare Enrolled Practice Location: 3950 Austell Rd, Austell, GA 30106 Phone: 770-732-4000 |