| Amita N Dave, Md Pc | |
|
3825 Medical Park Dr Suite 100 Austell GA 30106-6831 | |
| (770) 948-8680 | |
| (770) 944-1337 |
| Full Name | Amita N Dave, Md Pc |
|---|---|
| Speciality | Internal Medicine |
| Location | 3825 Medical Park Dr, Austell, Georgia |
| Authorized Official Name and Position | Amita N Dave (OWNER) |
| Authorized Official Contact | 7709488680 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Amita N Dave, Md Pc 3825 Medical Park Dr Suite 100 Austell GA 30106-6831 Ph: (770) 948-8680 | Amita N Dave, Md Pc 3825 Medical Park Dr Suite 100 Austell GA 30106-6831 Ph: (770) 948-8680 |
| NPI Number | 1639436439 |
|---|---|
| Provider Enumeration Date | 04/18/2012 |
| Last Update Date | 04/18/2012 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1639436439 | NPI | - | NPPES |
| 003116112A | Other | MEDICAID PAYEE ID NUMBER | |
| 000405402D | Medicaid | GA |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207R00000X | Internal Medicine | 023724 (Georgia) | Primary |
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