| Alpha Medical Wellness And Walk In Clinic Llc | |
|
130 Medical Way Suite B Stockbridge GA 30281 | |
| (678) 759-0059 | |
| (678) 623-8054 |
| Full Name | Alpha Medical Wellness And Walk In Clinic Llc |
|---|---|
| Speciality | Internal Medicine |
| Location | 130 Medical Way, Stockbridge, Georgia |
| Authorized Official Name and Position | Olusegun Osun (OFFICE MANAGER) |
| Authorized Official Contact | 6787590059 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Alpha Medical Wellness And Walk In Clinic Llc 130 Medical Way Suite B Stockbridge GA 30281 Ph: (678) 759-0059 | Alpha Medical Wellness And Walk In Clinic Llc 130 Medical Way Suite B Stockbridge GA 30281 Ph: (678) 759-0059 |
| NPI Number | 1053033522 |
|---|---|
| Provider Enumeration Date | 09/13/2022 |
| Last Update Date | 05/02/2023 |
| Medicare PECOS PAC ID | 5890152037 |
|---|---|
| Medicare Enrollment ID | O20230605000661 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1053033522 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207R00000X | Internal Medicine | (* (Not Available)) | Primary |
| Provider Name | Anthony Ayokunle Olofintuyi |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1144384827 PECOS PAC ID: 6709943566 Enrollment ID: I20090323000043 |
| Provider Name | Cheryl Marleise Samuel |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1588273692 PECOS PAC ID: 3779902077 Enrollment ID: I20201006003258 |
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