| Vitae Health Medical Georgia Llc | |
|
78 Opal St Cartersville GA 30120-2848 | |
| (770) 382-6120 | |
| Not Available |
| Full Name | Vitae Health Medical Georgia Llc |
|---|---|
| Speciality | Internal Medicine |
| Location | 78 Opal St, Cartersville, Georgia |
| Authorized Official Name and Position | Junaid Nawaz (PRESIDENT) |
| Authorized Official Contact | 2247778045 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Vitae Health Medical Georgia Llc 415 W Golf Rd Ste 26 Arlington Heights IL 60005-3923 Ph: (224) 777-8045 | Vitae Health Medical Georgia Llc 78 Opal St Cartersville GA 30120-2848 Ph: (770) 382-6120 |
| NPI Number | 1184320574 |
|---|---|
| Provider Enumeration Date | 02/07/2023 |
| Last Update Date | 03/24/2023 |
| Certification Date | 03/24/2023 |
| Medicare PECOS PAC ID | 4183079577 |
|---|---|
| Medicare Enrollment ID | O20231004002138 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1184320574 | NPI | - | NPPES |
| Provider Name | Michael K Frech |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1093076374 PECOS PAC ID: 6901032929 Enrollment ID: I20131122000386 |
| Provider Name | George Williams |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1104196161 PECOS PAC ID: 2961769641 Enrollment ID: I20201211001182 |
| Provider Name | Bryan B Collins |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1164774543 PECOS PAC ID: 5597984922 Enrollment ID: I20210401000434 |
| Provider Name | Courtney Elaine Buck |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1538727342 PECOS PAC ID: 9739586090 Enrollment ID: I20210929001373 |
| Provider Name | Houa Lee Lawson |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1790224160 PECOS PAC ID: 4981002540 Enrollment ID: I20211012001902 |
| Provider Name | Erica Michelle Grant |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1801170402 PECOS PAC ID: 4385860048 Enrollment ID: I20211201003175 |
| Provider Name | Jeronia Bowden |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1790248771 PECOS PAC ID: 8022485515 Enrollment ID: I20221114001976 |
| Provider Name | Thomas L Weaver |
|---|---|
| Provider Type | Practitioner - Clinical Psychologist |
| Provider Identifiers | NPI Number: 1235128323 PECOS PAC ID: 3375998784 Enrollment ID: I20231004002566 |
| Provider Name | Rachel Ducote Ross |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1609593201 PECOS PAC ID: 8426404609 Enrollment ID: I20231024002544 |
| Provider Name | Obiageli Gloria Moneke |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1124719273 PECOS PAC ID: 0143676106 Enrollment ID: I20231026003009 |
| Provider Name | Ashley Erkkila |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1023881976 PECOS PAC ID: 4587011382 Enrollment ID: I20231116001430 |
| Provider Name | Maureen Schuster |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1114782992 PECOS PAC ID: 6204272156 Enrollment ID: I20240313003501 |
| Provider Name | Alana Michelle Mitchell |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1952166001 PECOS PAC ID: 6800235227 Enrollment ID: I20240418002088 |
| Provider Name | Shirley Tate Chambers |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1831730456 PECOS PAC ID: 2163964867 Enrollment ID: I20240610002830 |
| Provider Name | Annika Marie Russaw |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1184056608 PECOS PAC ID: 5890238208 Enrollment ID: I20240613002237 |
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