| NPI | 1699290510 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | CHRISTY AQUINO Director Of Provider Enorllment 470-271-3427 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine |
| Additional Taxonomies | 261QM1300X Clinic/Center Multi-Specialty |
| Enumeration Date | 2017-08-11 |
| Last Update Date | 2023-02-06 |