| Ga Art Medical Clinic Pc | |
|
101 Colony Park Dr Ste 300 Cumming GA 30040-2751 | |
| (404) 999-2604 | |
| (404) 999-2587 |
| Full Name | Ga Art Medical Clinic Pc |
|---|---|
| Speciality | Clinic/Center |
| Location | 101 Colony Park Dr Ste 300, Cumming, Georgia |
| Authorized Official Name and Position | Gregory Buckley (MANAGER) |
| Authorized Official Contact | 4042901029 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Ga Art Medical Clinic Pc 890 Riverhaven Dr Suwanee GA 30024-4238 Ph: (404) 290-1029 | Ga Art Medical Clinic Pc 101 Colony Park Dr Ste 300 Cumming GA 30040-2751 Ph: (404) 999-2604 |
| NPI Number | 1699315002 |
|---|---|
| Provider Enumeration Date | 01/14/2020 |
| Last Update Date | 06/01/2022 |
| Medicare PECOS PAC ID | 6406285279 |
|---|---|
| Medicare Enrollment ID | O20200330001553 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1699315002 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261Q00000X | Clinic/center | (* (Not Available)) | Primary |
| Provider Name | Grace I Misaki |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1558340349 PECOS PAC ID: 0042318644 Enrollment ID: I20070605000597 |
| Provider Name | Antoine R Trammell |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1477752632 PECOS PAC ID: 7113012410 Enrollment ID: I20071002000262 |
| Provider Name | Joyce Ndichu |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1598315442 PECOS PAC ID: 2961832258 Enrollment ID: I20200429001657 |
| Provider Name | Stanley Wayne Himes |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1316047400 PECOS PAC ID: 4587730098 Enrollment ID: I20200807002623 |
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