| NPI | 1205981974 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MELIDA E. DELERME Internal Medicine Provider 404-464-0405 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261QF0400X Clinic/Center, Federally Qualified Health Center (FQHC) (Licence: AL 4326) |
| Enumeration Date | 2007-01-24 |
| Last Update Date | 2020-08-22 |