| Alpharetta Roswell Family Practice | |
|
2404 Macy Dr Roswell GA 30076-6343 | |
| (770) 640-8814 | |
| (770) 640-8815 |
| Full Name | Alpharetta Roswell Family Practice |
|---|---|
| Speciality | Family Medicine |
| Location | 2404 Macy Dr, Roswell, Georgia |
| Authorized Official Name and Position | Farzana B Mumtaz (OWNER) |
| Authorized Official Contact | 7706408814 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Alpharetta Roswell Family Practice 2404 Macy Dr Roswell GA 30076-6343 Ph: (770) 640-8814 | Alpharetta Roswell Family Practice 2404 Macy Dr Roswell GA 30076-6343 Ph: (770) 640-8814 |
| NPI Number | 1982783304 |
|---|---|
| Provider Enumeration Date | 11/05/2006 |
| Last Update Date | 11/23/2010 |
| Medicare PECOS PAC ID | 8426943606 |
|---|---|
| Medicare Enrollment ID | O20040217000599 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1982783304 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207Q00000X | Family Medicine | (* (Not Available)) | Primary |
| Provider Name | Farzana B Mumtaz |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1861571291 PECOS PAC ID: 8729973912 Enrollment ID: I20040218000018 |
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