| Dartmouth Medical, Llc | |
|
2959 Sharpsburg Mccullum Rd # 103 Newnan GA 30265-2297 | |
| (617) 610-9339 | |
| Not Available |
| Full Name | Dartmouth Medical, Llc |
|---|---|
| Speciality | Internal Medicine |
| Location | 2959 Sharpsburg Mccullum Rd # 103, Newnan, Georgia |
| Authorized Official Name and Position | Jian Liang Pang (CEO) |
| Authorized Official Contact | 6176109339 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Dartmouth Medical, Llc 2959 Sharpsburg Mccullum Rd # 103 Newnan GA 30265-2297 Ph: (770) 202-1642 | Dartmouth Medical, Llc 2959 Sharpsburg Mccullum Rd # 103 Newnan GA 30265-2297 Ph: (617) 610-9339 |
| NPI Number | 1679347033 |
|---|---|
| Provider Enumeration Date | 11/07/2023 |
| Last Update Date | 01/25/2024 |
| Medicare PECOS PAC ID | 7214387984 |
|---|---|
| Medicare Enrollment ID | O20231220003219 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1679347033 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207QA0505X | Family Medicine - Adult Medicine | (* (Not Available)) | Secondary |
| 207RE0101X | Internal Medicine - Endocrinology, Diabetes & Metabolism | (* (Not Available)) | Primary |
| Provider Name | Jian Liang Pang |
|---|---|
| Provider Type | Practitioner - Endocrinology |
| Provider Identifiers | NPI Number: 1558637058 PECOS PAC ID: 8921306325 Enrollment ID: I20180111000776 |
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