| NPI | 1386340669 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | CHASSIDY TEAL Authorized Official 404-985-7547 |
| Organization Subpart ? | No |
| Primary Taxonomy | 261Q00000X Clinic/Center |
| Additional Taxonomies | 207R00000X Internal Medicine |
| Enumeration Date | 2023-02-07 |
| Last Update Date | 2024-01-16 |