| NPI | 1164590576 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | DEEP SHAH Authorized Official 770-995-3300 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QM1300X Clinic/Center, Multi-Specialty |
| Additional Taxonomies | 173000000X Legal Medicine |
| 207Q00000X Family Medicine | |
| 207R00000X Internal Medicine | |
| 363L00000X Nurse Practitioner | |
| Enumeration Date | 2006-12-01 |
| Last Update Date | 2023-01-25 |