| Infectious Diseases Associates, Pc | |
|
6285 Garden Walk Blvd Ste A Riverdale GA 30274-2612 | |
| (770) 991-1500 | |
| (770) 991-9047 |
| Full Name | Infectious Diseases Associates, Pc |
|---|---|
| Speciality | Internal Medicine |
| Location | 6285 Garden Walk Blvd, Riverdale, Georgia |
| Authorized Official Name and Position | Pam Templeton (PRACTICE ADMINISTRATOR) |
| Authorized Official Contact | 7709911500 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Infectious Diseases Associates, Pc 6285 Garden Walk Blvd Ste A Riverdale GA 30274-2612 Ph: (770) 991-1500 | Infectious Diseases Associates, Pc 6285 Garden Walk Blvd Ste A Riverdale GA 30274-2612 Ph: (770) 991-1500 |
| NPI Number | 1689881989 |
|---|---|
| Provider Enumeration Date | 05/17/2007 |
| Last Update Date | 06/22/2011 |
| Medicare PECOS PAC ID | 6002800950 |
|---|---|
| Medicare Enrollment ID | O20040413000853 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1689881989 | NPI | - | NPPES |
| 1427064583 | Other | GA | NPI |
| 1548276603 | Other | GA | NPI |
| 1538216338 | Other | NPI |
| Provider Name | Richard C Prokesch |
|---|---|
| Provider Type | Practitioner - Infectious Disease |
| Provider Identifiers | NPI Number: 1427064583 PECOS PAC ID: 2668411570 Enrollment ID: I20060315000564 |
| Provider Name | Lee A Diamond |
|---|---|
| Provider Type | Practitioner - Infectious Disease |
| Provider Identifiers | NPI Number: 1548276603 PECOS PAC ID: 8921047838 Enrollment ID: I20060427000443 |
| Provider Name | Katherine Victoria White |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1699396630 PECOS PAC ID: 2163847385 Enrollment ID: I20200805002552 |
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