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2001 Peachtree Rd Ne Suite 640 Atlanta GA 30309-1476 | |
| (404) 355-3161 | |
| (404) 355-1353 |
| Full Name | |
|---|---|
| Speciality | Internal Medicine - Infectious Disease |
| Location | 2001 Peachtree Rd Ne, Atlanta, Georgia |
| Authorized Official Name and Position | Carlos E Lopez (PHYSICIAN/OWNER) |
| Authorized Official Contact | 4043553161 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
2001 Peachtree Rd Ne Suite 640 Atlanta GA 30309-1476 Ph: (404) 355-3161 | 2001 Peachtree Rd Ne Suite 640 Atlanta GA 30309-1476 Ph: (404) 355-3161 |
| NPI Number | 1619944279 |
|---|---|
| Provider Enumeration Date | 03/02/2006 |
| Last Update Date | 07/18/2011 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1619944279 | NPI | - | NPPES |
| 00211373B | Medicaid | GA | |
| 00466738B | Medicaid | GA |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207RI0200X | Internal Medicine - Infectious Disease | 19066 (Georgia) | Primary |
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