| NPI | 1043088495 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MICHAEL CULLEN Practice Administrator 770-531-3711 |
| Organization Subpart ? | Yes |
| Primary Taxonomy | 207RR0500X Internal Medicine Rheumatology |
| Additional Taxonomies | 332900000X Non-Pharmacy Dispensing Site |
| Enumeration Date | 2023-12-14 |
| Last Update Date | 2024-09-24 |