NPI | 1609887009 |
---|---|
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 | 2006-08-10 |
Last Update Date | 2023-01-24 |