| Atlanta Personalized Medicine Llc | |
|
5667 Peachtree Dunwoody Rd Ste 200 Atlanta GA 30342-1725 | |
| (678) 961-4100 | |
| Not Available |
| Full Name | Atlanta Personalized Medicine Llc |
|---|---|
| Speciality | Internal Medicine |
| Location | 5667 Peachtree Dunwoody Rd Ste 200, Atlanta, Georgia |
| Authorized Official Name and Position | David Fidel Rodriguez (PRESIDENT) |
| Authorized Official Contact | 6786625190 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Atlanta Personalized Medicine Llc 6240 Aberdeen Dr Atlanta GA 30328-4207 Ph: (678) 662-5190 | Atlanta Personalized Medicine Llc 5667 Peachtree Dunwoody Rd Ste 200 Atlanta GA 30342-1725 Ph: (678) 961-4100 |
| NPI Number | 1740947035 |
|---|---|
| Provider Enumeration Date | 11/21/2021 |
| Last Update Date | 01/06/2024 |
| Medicare PECOS PAC ID | 8123410412 |
|---|---|
| Medicare Enrollment ID | O20220118002679 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1740947035 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207R00000X | Internal Medicine | (* (Not Available)) | Primary |
| Provider Name | David F Rodriguez |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1376656447 PECOS PAC ID: 3971405721 Enrollment ID: I20040123000471 |
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