IndividualActive
Nicholas Beaulieu, M.D.
NPI 1679680557 · Preferred Provider Organization · Atlanta, GA
Provider details
- NPI number
- 1679680557
- Entity type
- Individual
- Primary specialty
- Preferred Provider OrganizationManaged Care Organizations
- Credential
- M.D.
- Sex
- Male
- Sole proprietor
- Yes
- License
- 42176 (GA)
Practice location
920 Ponce De Leon Ave Ne
920 Ponce De Leon Ave
Atlanta, GA 30306-4212
Phone: (404) 815-1957
Fax: (404) 815-1954
Mailing address
920 Ponce De Leon Ave Ne
Atlanta, GA 30306-4212
Registry dates
- Enumerated
- 2006-08-24
- Last updated
- 2022-09-29
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.