| Atlanta Prime Physicians Llc | |
|
10475 Medlock Bridge Rd Ste 420 Johns Creek GA 30097-4439 | |
| (602) 844-4855 | |
| Not Available |
| Full Name | Atlanta Prime Physicians Llc |
|---|---|
| Speciality | Internal Medicine |
| Location | 10475 Medlock Bridge Rd Ste 420, Johns Creek, Georgia |
| Authorized Official Name and Position | Sofia Khan (OWNER) |
| Authorized Official Contact | 6788152997 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Atlanta Prime Physicians Llc Po Box 2894 Duluth GA 30096-0050 Ph: (602) 844-4855 | Atlanta Prime Physicians Llc 10475 Medlock Bridge Rd Ste 420 Johns Creek GA 30097-4439 Ph: (602) 844-4855 |
| NPI Number | 1386145225 |
|---|---|
| Provider Enumeration Date | 02/26/2018 |
| Last Update Date | 05/31/2024 |
| Medicare PECOS PAC ID | 2668727082 |
|---|---|
| Medicare Enrollment ID | O20180626001040 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1386145225 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207R00000X | Internal Medicine | (* (Not Available)) | Primary |
| Provider Name | Sofia N Khan |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1699950220 PECOS PAC ID: 0345318150 Enrollment ID: I20121205000107 |
| Provider Name | Cynthia Moore |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1972225498 PECOS PAC ID: 0941641294 Enrollment ID: I20240517000095 |
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