| Katureebe Medical Associates, Pc | |
|
290 Blue Spruce Trl Lilburn GA 30047-7060 | |
| (617) 901-6120 | |
| Not Available |
| Full Name | Katureebe Medical Associates, Pc |
|---|---|
| Speciality | Family Medicine |
| Location | 290 Blue Spruce Trl, Lilburn, Georgia |
| Authorized Official Name and Position | Glenn Banegura (OWNER) |
| Authorized Official Contact | 6179016120 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Katureebe Medical Associates, Pc 290 Blue Spruce Trl Lilburn GA 30047-7060 Ph: (617) 901-6120 | Katureebe Medical Associates, Pc 290 Blue Spruce Trl Lilburn GA 30047-7060 Ph: (617) 901-6120 |
| NPI Number | 1831862325 |
|---|---|
| Provider Enumeration Date | 07/29/2021 |
| Last Update Date | 07/29/2021 |
| Medicare PECOS PAC ID | 9234534876 |
|---|---|
| Medicare Enrollment ID | O20210820000297 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1831862325 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207Q00000X | Family Medicine | (* (Not Available)) | Primary |
| 208M00000X | Hospitalist | (* (Not Available)) | Secondary |
| Provider Name | Glenn Banegura |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1770744989 PECOS PAC ID: 7315111010 Enrollment ID: I20140808002122 |
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