| Atlanta Center For Medicine Ii Pc | |
|
2801 N Decatur Rd Suite 300 Decatur GA 30033-5949 | |
| (404) 296-3111 | |
| (404) 297-7340 |
| Full Name | Atlanta Center For Medicine Ii Pc |
|---|---|
| Speciality | Clinic/Center |
| Location | 2801 N Decatur Rd, Decatur, Georgia |
| Authorized Official Name and Position | Maureen Carpenter (BUSINESS OFFICE MANAGER) |
| Authorized Official Contact | 4042963111 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Atlanta Center For Medicine Ii Pc 2801 N Decatur Rd Suite 300 Decatur GA 30033-5949 Ph: (404) 296-3111 | Atlanta Center For Medicine Ii Pc 2801 N Decatur Rd Suite 300 Decatur GA 30033-5949 Ph: (404) 296-3111 |
| NPI Number | 1669471728 |
|---|---|
| Provider Enumeration Date | 07/20/2005 |
| Last Update Date | 05/19/2015 |
| Medicare PECOS PAC ID | 5395914949 |
|---|---|
| Medicare Enrollment ID | O20110816000454 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1669471728 | NPI | - | NPPES |
| 055003002A | Medicaid | GA |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261Q00000X | Clinic/center | (* (Not Available)) | Primary |
| Provider Name | Ellen Ferguson |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1770541518 PECOS PAC ID: 8426038779 Enrollment ID: I20080423000557 |
| Provider Name | Larry G Ray |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1720029861 PECOS PAC ID: 4688866874 Enrollment ID: I20101006000620 |
| Provider Name | Thomas Jeffrey Mizell |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1205829561 PECOS PAC ID: 2264609114 Enrollment ID: I20120118000585 |
| Provider Name | Jitendra Singh |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1154321479 PECOS PAC ID: 6305013848 Enrollment ID: I20120125000630 |
| Provider Name | Dwayne T Daugherty |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1861493637 PECOS PAC ID: 0941477244 Enrollment ID: I20120126000440 |
| Provider Name | Steven John Anander |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1548354186 PECOS PAC ID: 5496012411 Enrollment ID: I20171129003410 |
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