| Idsa | |
|
2665 N Decatur Rd Suite 330 Decatur GA 30033-6149 | |
| (404) 297-9755 | |
| (404) 297-5008 |
| Full Name | Idsa |
|---|---|
| Speciality | Internal Medicine |
| Location | 2665 N Decatur Rd, Decatur, Georgia |
| Authorized Official Name and Position | Robin Henry Dretler (PRESIDENT) |
| Authorized Official Contact | 4042979755 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Idsa 2665 N Decatur Rd Suite 330 Decatur GA 30033-6149 Ph: (404) 297-9755 | Idsa 2665 N Decatur Rd Suite 330 Decatur GA 30033-6149 Ph: (404) 297-9755 |
| NPI Number | 1235170531 |
|---|---|
| Provider Enumeration Date | 06/09/2006 |
| Last Update Date | 08/20/2015 |
| Medicare PECOS PAC ID | 9032152376 |
|---|---|
| Medicare Enrollment ID | O20050607000937 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1235170531 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207RI0200X | Internal Medicine - Infectious Disease | (* (Not Available)) | Primary |
| Provider Name | Adam M Bressler |
|---|---|
| Provider Type | Practitioner - Infectious Disease |
| Provider Identifiers | NPI Number: 1154371870 PECOS PAC ID: 3375586530 Enrollment ID: I20050608000507 |
| Provider Name | Anson Kwame Wurapa |
|---|---|
| Provider Type | Practitioner - Infectious Disease |
| Provider Identifiers | NPI Number: 1871531442 PECOS PAC ID: 1456487941 Enrollment ID: I20100414000384 |
| Provider Name | Hieu Nguyen |
|---|---|
| Provider Type | Practitioner - Infectious Disease |
| Provider Identifiers | NPI Number: 1962455741 PECOS PAC ID: 6406983949 Enrollment ID: I20100415000088 |
| Provider Name | Milton Derrick Boden |
|---|---|
| Provider Type | Practitioner - Infectious Disease |
| Provider Identifiers | NPI Number: 1720037310 PECOS PAC ID: 8426185901 Enrollment ID: I20100415000444 |
| Provider Name | Robin Henry Dretler |
|---|---|
| Provider Type | Practitioner - Infectious Disease |
| Provider Identifiers | NPI Number: 1871545459 PECOS PAC ID: 5496882979 Enrollment ID: I20100519000012 |
| Provider Name | Alexandra Wolcott Dretler |
|---|---|
| Provider Type | Practitioner - Infectious Disease |
| Provider Identifiers | NPI Number: 1811251762 PECOS PAC ID: 2860621117 Enrollment ID: I20190813003533 |
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