| Board Of Regents Of The University System Of Georgia And On Behalf.... | |
|
141 Piedmont Ave Ne Ste D Atlanta GA 30303-2417 | |
| (404) 413-1930 | |
| (404) 413-1955 |
| Full Name | Board Of Regents Of The University System Of Georgia And On Behalf.... |
|---|---|
| Speciality | General Practice |
| Location | 141 Piedmont Ave Ne Ste D, Atlanta, Georgia |
| Authorized Official Name and Position | Susan Marie Whitmer (MEDICAL DIRECTOR) |
| Authorized Official Contact | 4044131930 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Board Of Regents Of The University System Of Georgia And On Behalf.... Po Box 3996 Atlanta GA 30302-3996 Ph: (404) 413-1930 | Board Of Regents Of The University System Of Georgia And On Behalf.... 141 Piedmont Ave Ne Ste D Atlanta GA 30303-2417 Ph: (404) 413-1930 |
| NPI Number | 1245965813 |
|---|---|
| Provider Enumeration Date | 07/19/2022 |
| Last Update Date | 07/19/2022 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1245965813 | NPI | - | NPPES |
| 1639373426 | Other | NPI |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 208D00000X | General Practice | (* (Not Available)) | Primary |
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