| NPI | 1629122684 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | LINDA MCCARD Billing Manager 770-963-7637 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: GA 022794) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: GA 056662) |
| Enumeration Date | 2007-01-23 |
| Last Update Date | 2020-08-22 |