| NPI | 1548219660 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | CHRISTY AQUINO Director Of Provider Enrollment 470-271-3427 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine |
| Additional Taxonomies | 207R00000X Internal Medicine |
| 207RC0000X Internal Medicine Cardiovascular Disease | |
| 207RN0300X Internal Medicine Nephrology | |
| Enumeration Date | 2006-05-08 |
| Last Update Date | 2025-06-26 |