| NPI | 1043967268 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | NICK SIDHU Physician 770-467-3975 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207RA0401X Internal Medicine Addiction Medicine |
| Additional Taxonomies | 208VP0000X Pain Medicine Pain Medicine |
| Enumeration Date | 2022-03-08 |
| Last Update Date | 2023-01-22 |