| Welgen One Of Georgia Llc | |
|
5415 Sugarloaf Pkwy Ste 1108 Lawrenceville GA 30043-7832 | |
| (833) 935-4361 | |
| Not Available |
| Full Name | Welgen One Of Georgia Llc |
|---|---|
| Speciality | General Practice |
| Location | 5415 Sugarloaf Pkwy Ste 1108, Lawrenceville, Georgia |
| Authorized Official Name and Position | Shanira Delacruz (PRESIDENT) |
| Authorized Official Contact | 2012332155 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Welgen One Of Georgia Llc 629 S 4th St Ste 301 Louisville KY 40202-2461 Ph: (201) 233-2155 | Welgen One Of Georgia Llc 5415 Sugarloaf Pkwy Ste 1108 Lawrenceville GA 30043-7832 Ph: (833) 935-4361 |
| NPI Number | 1023746732 |
|---|---|
| Provider Enumeration Date | 08/10/2022 |
| Last Update Date | 11/08/2022 |
| Certification Date | 11/08/2022 |
| Medicare PECOS PAC ID | 7315316452 |
|---|---|
| Medicare Enrollment ID | O20221212001041 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1023746732 | NPI | - | NPPES |
| Provider Name | Dinesh R Gandhi |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1568443273 PECOS PAC ID: 1850294364 Enrollment ID: I20200320001511 |
| Provider Name | Jayson Alan Weir |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1518257138 PECOS PAC ID: 2163647355 Enrollment ID: I20240524002095 |
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