| Mcdonough Adult & Pediatric Medical Care | |
|
130 Eagle Spring Ct Stockbridge GA 30281-7274 | |
| (678) 759-2278 | |
| Not Available |
| Full Name | Mcdonough Adult & Pediatric Medical Care |
|---|---|
| Speciality | Internal Medicine |
| Location | 130 Eagle Spring Ct, Stockbridge, Georgia |
| Authorized Official Name and Position | Musharaf Momin (PRESIDENT) |
| Authorized Official Contact | 4047831767 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Mcdonough Adult & Pediatric Medical Care 2437 Lake Erma Dr Hampton GA 30228-6087 Ph: (404) 783-1558 | Mcdonough Adult & Pediatric Medical Care 130 Eagle Spring Ct Stockbridge GA 30281-7274 Ph: (678) 759-2278 |
| NPI Number | 1932240124 |
|---|---|
| Provider Enumeration Date | 02/09/2007 |
| Last Update Date | 10/30/2019 |
| Medicare PECOS PAC ID | 1153594262 |
|---|---|
| Medicare Enrollment ID | O20111107000383 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1932240124 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207R00000X | Internal Medicine | (Georgia) | Primary |
| Provider Name | Musharaf Momin |
|---|---|
| Provider Type | Practitioner - Internal Medicine |
| Provider Identifiers | NPI Number: 1366483844 PECOS PAC ID: 0446285936 Enrollment ID: I20051004000418 |
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