| Health Star Family Medicine | |
|
4485 Tench Rd Suite No 120 Suwanee GA 30024-6739 | |
| (770) 932-7605 | |
| Not Available |
| Full Name | Health Star Family Medicine |
|---|---|
| Speciality | Family Medicine |
| Location | 4485 Tench Rd, Suwanee, Georgia |
| Authorized Official Name and Position | Usha Musunuru (OWNER) |
| Authorized Official Contact | 7709327605 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Health Star Family Medicine 4485 Tench Rd Suite No 120 Suwanee GA 30024-6739 Ph: (770) 932-7605 | Health Star Family Medicine 4485 Tench Rd Suite No 120 Suwanee GA 30024-6739 Ph: (770) 932-7605 |
| NPI Number | 1497953582 |
|---|---|
| Provider Enumeration Date | 07/10/2007 |
| Last Update Date | 03/22/2011 |
| Medicare PECOS PAC ID | 4183719289 |
|---|---|
| Medicare Enrollment ID | O20071004000457 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1497953582 | NPI | - | NPPES |
| 511G701213 | Other | GA | MEDICARE RAILROAD |
| APPLIED FOR | Other | GA | MEDICARE NO APPLIED FOR |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207Q00000X | Family Medicine | 055265 (Georgia) | Primary |
| Provider Name | Usha Musunuru |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1063445146 PECOS PAC ID: 0345201521 Enrollment ID: I20041021000091 |
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