Ms Matilda Mabel Antwi, NP | |
715 River Rush Dr, Sugar Hill, GA 30518-7465 | |
(630) 202-6958 | |
Not Available |
Full Name | Ms Matilda Mabel Antwi |
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Gender | Female |
Speciality | Family Medicine |
Location | 715 River Rush Dr, Sugar Hill, Georgia |
Accepts Medicare Assignments | Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs. |
Identifier | Type | State | Issuer |
---|---|---|---|
1649975731 | NPI | - | NPPES |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
207Q00000X | Family Medicine | F03230449 (Georgia) | Primary |
Entity Name | Northside Surgical Professional Services Llc |
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Entity Type | Part B Supplier - Clinic/group Practice |
Entity Identifiers | NPI Number: 1356630990 PECOS PAC ID: 8628253424 Enrollment ID: O20110420000598 |
Mailing Address | Practice Location Address |
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Ms Matilda Mabel Antwi, NP 715 River Rush Dr # 715, Sugar Hill, GA 30518-7465 Ph: (630) 202-6958 | Ms Matilda Mabel Antwi, NP 715 River Rush Dr, Sugar Hill, GA 30518-7465 Ph: (630) 202-6958 |
Dr. Jaydeep Kumar Radhakrishnan, M.D. Family Medicine Medicare: Accepting Medicare Assignments Practice Location: 1435 Broadmoor Blvd, Sugar Hill, GA 30518 Phone: 404-365-0966 | |
Jayashree Venkatesh, MD Family Medicine Medicare: Medicare Enrolled Practice Location: 1435 Broadmoor Blvd, Kaiser Permanente Sugar Hill-buford Medical Center, Sugar Hill, GA 30518 Phone: 678-765-5700 Fax: 540-636-8920 |