First Foundation Medical Clinic, P.c. | |
2930 Horizon Park Dr Suite C Suwanee GA 30024-7252 | |
(678) 546-2840 | |
(678) 546-2844 |
Full Name | First Foundation Medical Clinic, P.c. |
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Speciality | Internal Medicine |
Location | 2930 Horizon Park Dr, Suwanee, Georgia |
Authorized Official Name and Position | Julius Olukayode Ajayi (PRESIDENT) |
Authorized Official Contact | 6785462840 |
Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
Mailing Address | Practice Location Address |
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First Foundation Medical Clinic, P.c. 2930 Horizon Park Dr Suite C Suwanee GA 30024-7252 Ph: (678) 546-2840 | First Foundation Medical Clinic, P.c. 2930 Horizon Park Dr Suite C Suwanee GA 30024-7252 Ph: (678) 546-2840 |
NPI Number | 1306858337 |
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Provider Enumeration Date | 08/11/2006 |
Last Update Date | 03/20/2012 |
Medicare PECOS PAC ID | 2769569078 |
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Medicare Enrollment ID | O20080411000016 |
Identifier | Type | State | Issuer |
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1306858337 | NPI | - | NPPES |
Taxonomy | Type | License (State) | Status |
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207R00000X | Internal Medicine | 043843 (Georgia) | Primary |
Provider Name | Julius O Ajayi |
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Provider Type | Practitioner - Internal Medicine |
Provider Identifiers | NPI Number: 1013189364 PECOS PAC ID: 5193619062 Enrollment ID: I20040211000648 |
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