| Cerium Medical Group | |
|
2260 Northlake Pkwy Ste 300 Tucker GA 30084-4006 | |
| (404) 376-8325 | |
| Not Available |
| Full Name | Cerium Medical Group |
|---|---|
| Speciality | Clinic/Center |
| Location | 2260 Northlake Pkwy Ste 300, Tucker, Georgia |
| Authorized Official Name and Position | Sondi Saadia Moore-waters (PHYSICIAN) |
| Authorized Official Contact | 4042973440 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Cerium Medical Group 2260 Northlake Pkwy Ste 300 Tucker GA 30084-4006 Ph: (404) 297-3440 | Cerium Medical Group 2260 Northlake Pkwy Ste 300 Tucker GA 30084-4006 Ph: (404) 376-8325 |
| NPI Number | 1780076026 |
|---|---|
| Provider Enumeration Date | 02/24/2015 |
| Last Update Date | 12/12/2022 |
| Medicare PECOS PAC ID | 7517227770 |
|---|---|
| Medicare Enrollment ID | O20180207002410 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1780076026 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QP2300X | Clinic/center - Primary Care | (* (Not Available)) | Primary |
| Provider Name | Sondi S Moore-waters |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1508941501 PECOS PAC ID: 6204818024 Enrollment ID: I20040607000063 |
| Provider Name | Kiana Ohlson |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1851806244 PECOS PAC ID: 9032462635 Enrollment ID: I20181029002651 |
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