| Bethesda Medical Group, Llc | |
|
4039 Atlanta St Ste 100 Powder Springs GA 30127-2666 | |
| (770) 328-6398 | |
| (706) 793-9397 |
| Full Name | Bethesda Medical Group, Llc |
|---|---|
| Speciality | Family Medicine |
| Location | 4039 Atlanta St Ste 100, Powder Springs, Georgia |
| Authorized Official Name and Position | Albert Martin Edwards (PRESIDENT) |
| Authorized Official Contact | 7702411326 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Bethesda Medical Group, Llc Po Box 5 Powder Springs GA 30127-0005 Ph: (770) 328-6398 | Bethesda Medical Group, Llc 4039 Atlanta St Ste 100 Powder Springs GA 30127-2666 Ph: (770) 328-6398 |
| NPI Number | 1942686548 |
|---|---|
| Provider Enumeration Date | 08/05/2015 |
| Last Update Date | 10/08/2021 |
| Medicare PECOS PAC ID | 3971819624 |
|---|---|
| Medicare Enrollment ID | O20150826002052 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1942686548 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207Q00000X | Family Medicine | 30053 (Georgia) | Primary |
| Provider Name | Albert M Edwards |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1265505531 PECOS PAC ID: 0446443824 Enrollment ID: I20101018000842 |
| Provider Name | Patsy Bell Driver |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1770973232 PECOS PAC ID: 5597920686 Enrollment ID: I20160106001563 |
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