| Greater Atlanta Md Inc | |
|
301 Gwinnett Dr Ste D Lawrenceville GA 30046-5670 | |
| (678) 841-5240 | |
| (404) 759-2694 |
| Full Name | Greater Atlanta Md Inc |
|---|---|
| Speciality | Internal Medicine |
| Location | 301 Gwinnett Dr Ste D, Lawrenceville, Georgia |
| Authorized Official Name and Position | Falahat Ali Farooqui (CEO/PRESIDENT) |
| Authorized Official Contact | 6783335396 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Greater Atlanta Md Inc Po Box 681 Lawrenceville GA 30046-0681 Ph: () - | Greater Atlanta Md Inc 301 Gwinnett Dr Ste D Lawrenceville GA 30046-5670 Ph: (678) 841-5240 |
| NPI Number | 1760023121 |
|---|---|
| Provider Enumeration Date | 10/07/2019 |
| Last Update Date | 10/05/2021 |
| Medicare PECOS PAC ID | 2365870292 |
|---|---|
| Medicare Enrollment ID | O20200306002293 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1760023121 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207R00000X | Internal Medicine | (* (Not Available)) | Secondary |
| 207RG0300X | Internal Medicine - Geriatric Medicine | (* (Not Available)) | Primary |
| Provider Name | Falahat Farooqui |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1447693056 PECOS PAC ID: 2567718190 Enrollment ID: I20180711003284 |
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