| Dekalb Family Practice And Geriatrics | |
|
4961 Buford Hwy Ste 100 Chamblee GA 30341-3536 | |
| (606) 356-9322 | |
| Not Available |
| Full Name | Dekalb Family Practice And Geriatrics |
|---|---|
| Speciality | Clinic/Center |
| Location | 4961 Buford Hwy Ste 100, Chamblee, Georgia |
| Authorized Official Name and Position | Sudha Challa (OWNER) |
| Authorized Official Contact | 6063569322 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Dekalb Family Practice And Geriatrics 4961 Buford Hwy ,#100 Chamblee GA 30341 Ph: () - | Dekalb Family Practice And Geriatrics 4961 Buford Hwy Ste 100 Chamblee GA 30341-3536 Ph: (606) 356-9322 |
| NPI Number | 1447674775 |
|---|---|
| Provider Enumeration Date | 02/06/2014 |
| Last Update Date | 02/06/2014 |
| Medicare PECOS PAC ID | 5597996686 |
|---|---|
| Medicare Enrollment ID | O20140403000663 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1447674775 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261Q00000X | Clinic/center | 63641 (Georgia) | Primary |
| Provider Name | Sudha Challa |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1871756627 PECOS PAC ID: 1850574609 Enrollment ID: I20140403000824 |
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