Donnelly, Edwin H.

Donnelly, Edwin H. is an sole proprietor health care provider with primary practice located at 975 Johnson Ferry Rd Ne Suite 370, Atlanta GA 30342-1619. He recently has 2 registered licenses in different health care specialties including Allopathic & Osteopathic Physicians / Ophthalmology, Allopathic & Osteopathic Physicians / Retina Specialist. Allopathic & Osteopathic Physicians / Retina Specialist is his primary health care specialty. Donnelly, Edwin H. can be contacted via phone (404) 250-1242.

Contact Information

Primary practice address
975 Johnson Ferry Rd Ne Suite 370 Atlanta GA 30342-1619
Phone: (404) 250-1242
Fax: (404) 250-1232
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Ophthalmology 207W00000X 019156 Georgia
Allopathic & Osteopathic Physicians / Retina Specialist 207WX0107X 019156 Georgia

Profile Details

NPI number 1053315457
LBN Legal business name Donnelly, Edwin H.
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 Yes
Enumeration date Jun 13th, 2005
Last updated Oct 4th, 2017 - about 9 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1053315457 NPPES
Georgia Other 581425151 TAX ID
Georgia MEDICAID 00154206B TAX ID

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