| Infectious Disease Consultants, Pc | |
|
5400 Laurel Springs Pkwy Ste 1404 Suwanee GA 30024-6098 | |
| (678) 347-2153 | |
| Not Available |
| Full Name | Infectious Disease Consultants, Pc |
|---|---|
| Speciality | Internal Medicine |
| Location | 5400 Laurel Springs Pkwy Ste 1404, Suwanee, Georgia |
| Authorized Official Name and Position | John Kyle Stellbauer (COO) |
| Authorized Official Contact | 6783472153 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Infectious Disease Consultants, Pc 5400 Laurel Springs Pkwy Ste 1404 Suwanee GA 30024-6098 Ph: (678) 347-2153 | Infectious Disease Consultants, Pc 5400 Laurel Springs Pkwy Ste 1404 Suwanee GA 30024-6098 Ph: (678) 347-2153 |
| NPI Number | 1225087745 |
|---|---|
| Provider Enumeration Date | 05/10/2006 |
| Last Update Date | 09/09/2022 |
| Medicare PECOS PAC ID | 4587550298 |
|---|---|
| Medicare Enrollment ID | O20040227000322 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1225087745 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207RI0200X | Internal Medicine - Infectious Disease | (* (Not Available)) | Primary |
| Provider Name | Tzvetan Vassilev |
|---|---|
| Provider Type | Practitioner - Infectious Disease |
| Provider Identifiers | NPI Number: 1619980893 PECOS PAC ID: 6406822824 Enrollment ID: I20040908000220 |
| Provider Name | Karuna Kusan |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1013921329 PECOS PAC ID: 6305877556 Enrollment ID: I20050826000634 |
| Provider Name | Andrew Pugliese |
|---|---|
| Provider Type | Practitioner - Infectious Disease |
| Provider Identifiers | NPI Number: 1942258314 PECOS PAC ID: 9133141237 Enrollment ID: I20060103000371 |
| Provider Name | Andrew B Dold |
|---|---|
| Provider Type | Practitioner - Infectious Disease |
| Provider Identifiers | NPI Number: 1073718516 PECOS PAC ID: 2163482548 Enrollment ID: I20080428000016 |
| Provider Name | Daniel Ketterer |
|---|---|
| Provider Type | Practitioner - Infectious Disease |
| Provider Identifiers | NPI Number: 1134393796 PECOS PAC ID: 5193955771 Enrollment ID: I20140226001782 |
| Provider Name | Myrna Gacusan |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1174976088 PECOS PAC ID: 1658620489 Enrollment ID: I20180827003660 |
| Provider Name | Kimberly D Paris |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1144756255 PECOS PAC ID: 8921425976 Enrollment ID: I20200904001276 |
| Provider Name | Marissa Cook Sheridan |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1427344746 PECOS PAC ID: 7416125430 Enrollment ID: I20210120002946 |
| Provider Name | Zola Nlandu |
|---|---|
| Provider Type | Practitioner - Infectious Disease |
| Provider Identifiers | NPI Number: 1821451873 PECOS PAC ID: 8527350479 Enrollment ID: I20211219000022 |
| Provider Name | Michael Raymond Butzen |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1760036776 PECOS PAC ID: 3870987316 Enrollment ID: I20220228001640 |
| Provider Name | Brooke Matthews |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1093271918 PECOS PAC ID: 1759775810 Enrollment ID: I20220307000894 |
| Provider Name | Steven Spires |
|---|---|
| Provider Type | Practitioner - Infectious Disease |
| Provider Identifiers | NPI Number: 1043453632 PECOS PAC ID: 2062677693 Enrollment ID: I20231002001211 |
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