| Atlanta Internal Medicine Pc | |
|
2400 Pleasant Hill Rd Suite 300 Duluth GA 30096-4396 | |
| (770) 858-5252 | |
| Not Available |
| Full Name | Atlanta Internal Medicine Pc |
|---|---|
| Speciality | Clinic/Center |
| Location | 2400 Pleasant Hill Rd, Duluth, Georgia |
| Authorized Official Name and Position | Jo Kim (CEO) |
| Authorized Official Contact | 7708585252 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Atlanta Internal Medicine Pc 2400 Pleasant Hill Rd Suite 300 Duluth GA 30096-4396 Ph: (770) 858-5252 | Atlanta Internal Medicine Pc 2400 Pleasant Hill Rd Suite 300 Duluth GA 30096-4396 Ph: (770) 858-5252 |
| NPI Number | 1639567472 |
|---|---|
| Provider Enumeration Date | 01/02/2015 |
| Last Update Date | 01/03/2015 |
| Medicare PECOS PAC ID | 7416274139 |
|---|---|
| Medicare Enrollment ID | O20150317002927 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1639567472 | NPI | - | NPPES |
| 003109338A | Medicaid | GA |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QP2300X | Clinic/center - Primary Care | 64660 (Georgia) | Primary |
| Provider Name | Jo M Kim |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1205092921 PECOS PAC ID: 4385782770 Enrollment ID: I20101027000903 |
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