| Conyers Internal Medicine Llc | |
|
1380 Milstead Ave Ne Ste C Conyers GA 30012-3864 | |
| (770) 922-7000 | |
| Not Available |
| Full Name | Conyers Internal Medicine Llc |
|---|---|
| Speciality | Internal Medicine |
| Location | 1380 Milstead Ave Ne, Conyers, Georgia |
| Authorized Official Name and Position | Naseem K Shakoor (OWNER) |
| Authorized Official Contact | 7709227000 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Conyers Internal Medicine Llc 1380 Milstead Ave Ne Ste C Conyers GA 30012-3864 Ph: (770) 922-7000 | Conyers Internal Medicine Llc 1380 Milstead Ave Ne Ste C Conyers GA 30012-3864 Ph: (770) 922-7000 |
| NPI Number | 1063752913 |
|---|---|
| Provider Enumeration Date | 02/28/2013 |
| Last Update Date | 02/28/2013 |
| Medicare PECOS PAC ID | 0042455974 |
|---|---|
| Medicare Enrollment ID | O20130326000232 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1063752913 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207R00000X | Internal Medicine | (Georgia) | Primary |
| Provider Name | Naseem K Shakoor |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1821109463 PECOS PAC ID: 1355373176 Enrollment ID: I20050901000140 |
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